Individual provider Active NPI

Lori Nicole Moore, NP

  • Family Nurse Practitioner
  • Williamsburg, VA
National Provider Identifier
1922875210
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024188896 Issued in VA
Practice address
4374 New Town Ave Ste 200
Williamsburg, VA 23188-2865
Phone
(757) 984-6095
NPI assigned
Dec 6, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

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 0024188896 VA Primary

Addresses

Primary practice location

4374 New Town Ave Ste 200
Williamsburg, VA 23188-2865

Mailing address

4374 New Town Ave Ste 200
Williamsburg, VA 23188-2865
Phone (757) 984-6095

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20240416001569 VA Practitioner - Nurse Practitioner 0042659666 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sentara Medical GroupGroup PAC ID 8921903923, 1,396 clinicians

Practice addresses (Care Compare)

4374 New Town Ave
Suite 200
Williamsburg, VA 23188-2865
Phone (757) 220-2795

Hospital & facility affiliations

  • Sentara Home Care Services-Williamsburg Home health agency, Williamsburg, VA, CCN 497748
  • Sentara Williamsburg Regional Medical Center Hospital, Williamsburg, VA, CCN 490066
  • Sentara Careplex Hospital Hospital, Hampton, VA, CCN 490093
  • Riverside Regional Medical Center Hospital, Newport News, VA, CCN 490052

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sentara Medical Group CurrentSince Feb 1, 2024 Accepting new patients

Locations

850 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-0162

4374 New Town Ave
Ste 200
Williamsburg, VA 23188
Phone (757) 220-2795

Interoperability endpoints

  • Direct secure messaging: lmoore874728@direct.sentara.net

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": "1701820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1922875210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4374 NEW TOWN AVE STE 200",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231882865",
            "telephone_number": "757-984-6095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4374 NEW TOWN AVE STE 200",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231882865",
            "telephone_number": "757-984-6095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "LORI",
        "middle_name": "NICOLE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-06",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024188896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsburg, VA

Sources for this page

Verify at the official NPI Registry.