MISS HOLLY SUZANNE MOORE (NPI# 1255648390) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255648390 |
| Entity Type | Individual |
| Full Name | MISS HOLLY SUZANNE MOORE |
| Credential | MSOTR/L |
| Practice Address |
202 West Davenport Street Crossville IL 62827 |
| Practice Telephone | 6189284801 |
| Mailing Telephone | 6189284801 |
| Enumeration Date | 2010-09-10 |
| Last Update Date | 2010-09-10 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 056.008560 | IL | Nursing & Custodial Care Facilities |
| N | 314000000X | Skilled Nursing Facility | 31004566A | IN | Nursing & Custodial Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902363906 | Holly Moore | Psychologist | 281 Pennsylvania Ave, Massapequa Park, NY 11762-2846 | 2019-02-26 |
| 1801325477 | Holly Elizabeth Moore | Counselor | 2000 W Briggsmore Ave Ste 1, Modesto, CA 95350-3839 | 2017-06-07 |
| 1063704369 | Holly E Moore | Counselor | 31 Morrow St, Mansfield, MA 02048-1322 | 2011-05-05 |
| 1992994479 | Holly D Moore | Counselor | 212 Cherokee Rd, Thomaston, GA 30286-3402 | 2007-10-19 |
| 1659982411 | Holly Marie Moore | Nurse Practitioner | 2 Saint Vincent Cir, Little Rock, AR 72205-5423 | 2020-08-13 |
| 1578120986 | Holly Reith Moore | Licensed Practical Nurse | 35 12th St Se, Paris, TX 75460-6006 | 2019-05-21 |
| 1568944478 | Holly Marie Moore | Counselor | 720 Wood St, Eureka, CA 95501-4413 | 2018-09-06 |
| 1598277899 | Holly Truong Moore | Nurse Practitioner | 300 Pasteur Dr, Palo Alto, CA 94304-2203 | 2017-10-27 |
| 1215333679 | Holly Lynn Moore | Social Worker | 9724 Kingston Pike, Suite 405, Knoxville, TN 37922-3347 | 2014-11-13 |
| 1417367897 | Holly Kebodeaux Moore | Speech-Language Pathologist | 211 N 3rd St, Suite 1, Monroe, LA 71201-6731 | 2014-05-06 |
| Street Address |
202 WEST DAVENPORT STREET |
| City | CROSSVILLE |
| State | IL |
| Zip Code | 62827 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740898345 | Briley Zayne Tolley | Speech-Language Pathologist | 507 S State St, Crossville, IL 62827-1121 | 2020-07-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730788274 | Gary Justin Farr | Massage Therapist | 978 Fred Ford Rd, Crossville, TN 38571-0261 | 2020-10-24 |
| 1366056681 | Courtney Denise Clark | Counselor | 502 Mockingbird Dr, Crossville, TN 38555-5836 | 2020-09-03 |
| 1467065326 | Kevin Melanio Corvacho | Dentist | 2854 N Main St Ste 102, Crossville, TN 38555-5413 | 2020-08-28 |
| 1093325557 | Highland Behavioral Healthcare | Nurse Practitioner | 29 Taylor Ave Ste 204, Crossville, TN 38555-4537 | 2020-08-08 |
| 1134757370 | Zachary Ebel | Hearing Instrument Specialist | 119 Birchwood Ln, Crossville, TN 38555-4189 | 2020-04-01 |
| 1821625096 | Dennis James Sattler | Counselor | 10429 Highway 127 S, Crossville, TN 38572-1393 | 2020-03-26 |
| 1134753635 | Act Now, LLC | Social Worker | 1791 County Road 537, Crossville, AL 35962-3042 | 2020-02-24 |
| 1679106306 | North Main Medical, LLC | Family Medicine | 3094 N Mainst, Crossville, TN 38555 | 2020-02-21 |
| 1740827088 | Molly Marie Trotter | Licensed Practical Nurse | 101 Banbury Ln, Crossville, TN 38558-6804 | 2019-12-05 |
| 1013566991 | Arehart Enterprises Plc | Anesthesiology | 181 Matherly Street, Crossville, TN 38555 | 2019-09-04 |
| Find all providers in CROSSVILLE | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245539576 | The Evangelical Lutheran Good Samaritan Society | Skilled Nursing Facility | 100 Samaritan Way, Crossville, TN 38558 | 2011-03-25 |
| 1154572618 | Crossville Medical Investors, LLC | Skilled Nursing Facility | 80 Justice St, Crossville, TN 38555-4744 | 2008-10-02 |
| 1073523692 | Country Place Health Care Center | Skilled Nursing Facility | 80 Justice Street, Crossville, TN 38555 | 2006-08-08 |
| 1982644951 | Crossville Health Realty, LLC | Skilled Nursing Facility | 8922 Highway 227 North, Crossville, AL 35962 | 2006-06-07 |
| 1336200526 | Crossville Health and Rehabilitation LLC | Skilled Nursing Facility | 8922 Highway 227 North, Crossville, AL 35962 | 2006-12-12 |
| 1275621690 | Cumberland Medical Center, Inc. | Skilled Nursing Facility | 421 South Main Street, Crossville, TN 38555 | 2006-10-11 |
| 1427066786 | Slf No. 1 LLC | Skilled Nursing Facility | 456 Wayne Ave, Crossville, TN 38555-4206 | 2006-08-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902413537 | Citadel of Glenview LLC | Skilled Nursing Facility | 1700 E Lake Ave, Glenview, IL 60025-2003 | 2020-09-28 |
| 1598379075 | Patient Builders Marketing | Skilled Nursing Facility | 800 W Army Trail Rd, Carol Stream, IL 60188-9040 | 2020-09-02 |
| 1730790817 | Ih Fox Valley Opco, LLC | Skilled Nursing Facility | 4020 E New York St, Aurora, IL 60504-4416 | 2020-08-12 |
| 1902428147 | Aperion Care Glenwood LLC | Skilled Nursing Facility | 19330 South College Grove, Glenwood, IL 60425 | 2020-05-11 |
| 1487273330 | Residential Alternatives of Illinois, Inc | Skilled Nursing Facility | 2203 Flagg Rd, Rochelle, IL 61068 | 2020-04-10 |
| 1932728003 | Tco Jv, LLC | Skilled Nursing Facility | 550 Ridgeview Drive, Mchenry, IL 60050 | 2020-04-09 |
| 1841825510 | Ih Lisle Opco, LLC | Skilled Nursing Facility | 2850 Ogden Avenue, Lisle, IL 60532 | 2020-03-03 |
| 1114550381 | Rosiclare Hco, LLC | Skilled Nursing Facility | 55 Ferrell Rd, Rosiclare, IL 62982-1006 | 2020-02-17 |
| 1225672033 | All Ways Caring Services, Inc. | Skilled Nursing Facility | 301 N Neil St Ste 301, Champaign, IL 61820-3167 | 2019-11-05 |
| 1578036695 | Heartland Nursing & Rehabilitation LLC | Skilled Nursing Facility | 410 Nw 3rd St, Casey, IL 62420-1014 | 2019-01-11 |
| Find all providers with the same taxonomy | ||||
| City | CROSSVILLE |
| Zip Code | 62827 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.