Individual provider Active NPI

Amber Moore, FNP

  • Family Nurse Practitioner
  • Troy, MO
National Provider Identifier
1922548627
Registry record updated Mar 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2017002502 Issued in MO
Practice address
1165 E Cherry St
Troy, MO 63379-1520
Phone
(636) 528-1919
NPI assigned
Feb 28, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2019

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 2017002502 MO Primary

Addresses

Primary practice location

1165 E Cherry St
Troy, MO 63379-1520

Mailing address

1165 E Cherry St
Troy, MO 63379-1520
Phone (636) 525-1919

Other identifiers 1

IdentifierTypeStateIssuer
420060667MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181106002044 MO Practitioner - Nurse Practitioner 7810241015 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Hospital LincolnGroup PAC ID 5193040020, 31 clinicians

Practice addresses (Care Compare)

1165 E Cherry St
Troy, MO 63379-1520
Phone (636) 528-7722

Hospital & facility affiliations

  • Mercy Hospital Lincoln Hospital, Troy, MO, CCN 261319
  • Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital Lincoln CurrentSince Oct 22, 2018 Accepting new patients
Mercy Hospital Lincoln CurrentSince Oct 22, 2018 Accepting new patients

Locations

1165 E Cherry St
Troy, MO 63379
Phone (636) 528-1919

900 E Cherry St
Troy, MO 63379
Phone (636) 528-8585

Interoperability endpoints

  • Direct secure messaging: amoore1004190@directc.mercy.net

Organizations & group practices 2

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

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1488240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552262400000",
    "number": "1922548627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1165 E CHERRY ST",
            "city": "TROY",
            "state": "MO",
            "postal_code": "633791520",
            "telephone_number": "636-525-1919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1165 E CHERRY ST",
            "city": "TROY",
            "state": "MO",
            "postal_code": "633791520",
            "telephone_number": "636-528-1919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "AMBER",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-28",
        "last_updated": "2019-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2017002502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "420060667",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MO

Sources for this page

Verify at the official NPI Registry.