NPIMap

Individual provider Active NPI

Tamra Edwana Moss, APRN

  • Family Nurse Practitioner
  • Columbia, KY
National Provider Identifier
1912340449
Registry record updated Oct 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3007062 Issued in KY
Practice address
197 Will Walker Rd
Columbia, KY 42728-7436
Phone
(270) 384-9981
Fax
(270) 384-9989
NPI assigned
Apr 15, 2013
Last updated
Oct 4, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3007062 KY Primary

Addresses

Primary practice location

197 Will Walker Rd
Columbia, KY 42728-7436

Mailing address

PO Box 1080
Burkesville, KY 42717-1080
Phone (270) 864-1472

Other identifiers 2

IdentifierTypeStateIssuer
3007062OtherKYKENTUCKY STATE LICENSE NUMBER
7100242650MedicaidKY

Other names 1

  • Tamra Edwana Atwood Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130605000838 KY Practitioner - Nurse Practitioner 1951549781 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1417 N Main St
Jamestown, KY 42629-2411
Phone (270) 343-2597

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3007062KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jamestown Healthcare Clinic LLC Current Accepting new patients
Cumberland Family Medical Center Inc CurrentSince Apr 25, 2016 Accepting new patients
Cumberland Family Medical Center Inc PastSince Oct 30, 2022 Accepting new patients
Cumberland Family Medical Center Inc PastSince Oct 30, 2022 Accepting new patients
Cumberland Family Medical Center Inc Past Accepting new patients
Cumberland Family Medical Center Inc PastSince Oct 23, 2022 Accepting new patients
Cumberland Family Medical Center Inc PastSince Oct 23, 2022 Accepting new patients
Cumberland Family Medical Center, Inc. PastSince Oct 30, 2022 Accepting new patients

Locations

1417 N Main St
Jamestown, KY 42629
Phone (270) 343-2597

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1365984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696377600000",
    "number": "1912340449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1080",
            "city": "BURKESVILLE",
            "state": "KY",
            "postal_code": "427171080",
            "telephone_number": "270-864-1472",
            "fax_number": "270-864-1693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "197 WILL WALKER RD",
            "city": "COLUMBIA",
            "state": "KY",
            "postal_code": "427287436",
            "telephone_number": "270-384-9981",
            "fax_number": "270-384-9989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSS",
        "first_name": "TAMRA",
        "middle_name": "EDWANA",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-15",
        "last_updated": "2023-10-04",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3007062",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KENTUCKY STATE LICENSE NUMBER",
            "identifier": "3007062",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100242650",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAMRA",
            "last_name": "ATWOOD",
            "middle_name": "EDWANA",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Columbia, KY

Sources for this page

Verify at the official NPI Registry.