Tera N Moore, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024176700 Issued in VA

Practice address

4019 Cobblewood Dr
Disputanta, VA 23842-4518

Phone

(757) 724-7310

NPI assigned

Oct 3, 2018

Last updated

Jun 8, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Carelon Medical Partners, PC

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  • Nashville, TN
  • NPI 1124443403

  VA

  Medicare reassignment NPD
• Consonant Healing Medical Associates

  • Surgery Physician
  • Silver Spring, MD
  • NPI 1588122535

  VA

  Medicare reassignment NPD
• More Wellness Medical Clinic LLC

  • Nurse Practitioner
  • Disputanta, VA
  • NPI 1154296408
  NPD Authorized official

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

{
    "created_epoch": "1538524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623110400000",
    "number": "1942785167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4019 COBBLEWOOD DR",
            "city": "DISPUTANTA",
            "state": "VA",
            "postal_code": "238424518",
            "telephone_number": "757-724-7310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4019 COBBLEWOOD DR",
            "city": "DISPUTANTA",
            "state": "VA",
            "postal_code": "238424518",
            "telephone_number": "757-724-7310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "TERA",
        "middle_name": "N",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-03",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024176700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dominique King
• Tony Roosevelt King, M.D.
• Cory Andrew Lane, M.S. CCC-SLP
• Loving Hands Homecare LLC
• Magnolia Woods, LLC
• More Wellness Medical Clinic LLC
• Shawana Roach
• Tyesha Shaw
• Southern Living Child Care LLC
• Southern Living Services LLC

• Family Nurse Practitioner in Disputanta, VA
• Providers in Disputanta, VA by specialty
• Family Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.