Individual provider Active NPI

Ernest E Moore, D.D.S

  • Dentist
  • Roanoke, VA
National Provider Identifier
1972543957
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401008741 Issued in VA
Practice address
4348 Electric Rd
Roanoke, VA 24018-0720
Phone
(540) 769-0600
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 0401008741 VA
Dentist 122300000X 0401008741 VA Primary

Addresses

Primary practice location

4348 Electric Rd
Roanoke, VA 24018-0720

Mailing address

213 S Jefferson St Ste 1006
Roanoke, VA 24011-1713

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131114001864 VA Practitioner - Oral Surgery 0446486757 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Oral Surgery
Education
Virginia Commonwealth University, School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carilion Medical CenterGroup PAC ID 9830096585, 956 clinicians

Practice addresses (Care Compare)

2017 S Jefferson St
Roanoke, VA 24014-2419
Phone (540) 981-7128

Hospital & facility affiliations

  • Carilion Medical Center Hospital, Roanoke, VA, CCN 490024

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0401008741VAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Medical Center CurrentSince Nov 18, 2013 Accepting new patients
Carilion Franklin Memorial Hospital CurrentSince Apr 12, 2024 Accepting new patients
Carilion Healthcare Corporation CurrentSince Apr 12, 2024 Accepting new patients
Carilion Healthcare Corporation CurrentSince Apr 12, 2024 Accepting new patients
Carilion Medical Center Current Accepting new patients
Carilion Franklin Memorial Hospital CurrentSince Apr 12, 2024 Accepting new patients
Carilion Medical Center CurrentSince Nov 18, 2013 Accepting new patients

Locations

2017 Jefferson St SW
Roanoke, VA 24014
Phone (540) 981-7128

6415 Peters Creek Rd
Roanoke, VA 24019
Phone (703) 562-2110

4348 Electric Rd
Roanoke, VA 24018
Phone (540) 769-0600

213 S Jefferson St
Ste 1006
Roanoke, VA 24011
Phone (540) 224-5353

180 Floyd Ave
Rocky Mount, VA 24151
Phone (540) 483-5277

Interoperability endpoints

  • Direct secure messaging: emoore56176@direct.carilionclinic.org

Organizations & group practices 7

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 1

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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1972543957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 S JEFFERSON ST STE 1006",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240111713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4348 ELECTRIC RD",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240180720",
            "telephone_number": "540-769-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ERNEST",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401008741",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401008741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.