NPIMap

Individual provider Active NPI

Destiny Moore Moss, APRN

  • Family Nurse Practitioner
  • Spartanburg, SC
National Provider Identifier
1972997179
Registry record updated Sep 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
19365 Issued in SC
Practice address
391 Serpentine Dr
Suite 500
Spartanburg, SC 29303-3096
Phone
(864) 585-8221
NPI assigned
Mar 25, 2015
Last updated
Sep 25, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2015

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 19365 SC Primary

Addresses

Primary practice location

391 Serpentine Dr
Suite 500
Spartanburg, SC 29303-3096

Mailing address

391 Serpentine Dr
Suite 500
Spartanburg, SC 29303-3096
Phone (864) 585-8221

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161220000601 SC Practitioner - Nurse Practitioner 9032490685 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spartanburg Medical CenterGroup PAC ID 3072425297, 1,060 clinicians

Practice addresses (Care Compare)

101 E Wood St
Spartanburg, SC 29303-3040
Phone (864) 560-1576

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.7 of 100Reported as apm
Quality
89.4
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19365SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Spartanburg Medical Center Current Accepting new patients
Spartanburg Medical Center CurrentSince Dec 1, 2021 Accepting new patients
Spartanburg Medical Center CurrentSince Dec 1, 2021 Accepting new patients
Spartanburg Medical Center Past Accepting new patients
Upstate Carolina Radiology PA PastSince Oct 18, 2016 Accepting new patients

Locations

101 E Wood St
Spartanburg, SC 29303
Phone (864) 560-1915

391 Serpentine Dr
Ste 500
Spartanburg, SC 29303
Phone (864) 585-8221

853 N Church St
Ste 410A
Spartanburg, SC 29303
Phone (864) 560-6928

Organizations & group practices 5

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.

Hospital & facility affiliations 6

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": "1427241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443139200000",
    "number": "1972997179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "391 SERPENTINE DR",
            "address_2": "SUITE 500",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293033096",
            "telephone_number": "864-585-8221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "391 SERPENTINE DR",
            "address_2": "SUITE 500",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293033096",
            "telephone_number": "864-585-8221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSS",
        "first_name": "DESTINY",
        "middle_name": "MOORE",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-25",
        "last_updated": "2015-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "19365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

Verify at the official NPI Registry.