Individual provider Active NPI

Tierni Ann Moore, MD

  • Family Medicine Physician
  • Springfield, OH
National Provider Identifier
1922687037
Registry record updated Apr 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35149482 Issued in OH
Practice address
280 Red Coach Dr
Springfield, OH 45503-1297
Phone
(937) 399-3010
Fax
(937) 399-3020
NPI assigned
Apr 6, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X OH
Family Medicine Physician 207Q00000X 35149482 OH Primary

Addresses

Primary practice location

280 Red Coach Dr
Springfield, OH 45503-1297

Mailing address

280 Red Coach Dr
Springfield, OH 45503-1297
Phone (937) 399-3010

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240702002957 OH Practitioner - Family Practice 5890195820 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Ohio State University College of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northside Family Physicians, LTD.Group PAC ID 1254310550, 6 clinicians

Practice addresses (Care Compare)

280 Red Coach Dr
Springfield, OH 45503-1297
Phone (937) 399-3010

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35149482OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Family Physicians, LTD. Family Medicine CurrentSince Aug 1, 2024 Accepting new patients

Locations

280 Red Coach Dr
Springfield, OH 45503
Phone (937) 399-3010

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.1332

Organizations & group practices 1

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 4

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": "1617667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743984000000",
    "number": "1922687037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 RED COACH DR",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455031297",
            "telephone_number": "937-399-3010",
            "fax_number": "937-399-3020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 RED COACH DR",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455031297",
            "telephone_number": "937-399-3010",
            "fax_number": "937-399-3020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "TIERNI",
        "middle_name": "ANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-06",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35149482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OH

Sources for this page

Verify at the official NPI Registry.