PHYLLIS EUGENIA MOORE


Address: 100 Mallard Creek Rd, Suite 406, Louisville, KY 40207-4194
Phone: 5028954607

PHYLLIS EUGENIA MOORE (NPI# 1497130017) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1497130017
Entity Type Individual
Full Name PHYLLIS EUGENIA MOORE
Credential APRN
Practice Address 100 Mallard Creek Rd
Suite 406
Louisville
KY 40207-4194
Mailing Address 141 N Crestmoor Ave
Louisville
KY 40206-2771
Practice Telephone 5028954607
Practice Fax Number 5028954586
Mailing Telephone 5024892608
Enumeration Date 2015-07-24
Last Update Date 2020-10-26
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LF0000X Nurse Practitioner
Specialization: Family
3009442 KY Physician Assistants & Advanced Practice Nursing Providers

Other Providers PHYLLIS MOORE

NPI Name Taxonomy Address Enumeration
1134330483 Phyllis C. Moore Speech-Language Pathologist 5111 Laird Ln, Jupiter, FL 33458-4095 2007-05-25
1023374279 Phyllis P Moore Nurse Practitioner 600 Main St, Friendship, TN 38034-1999 2012-04-02
1235407248 Phyllis Ann Moore Nurse Practitioner 815 Pennsylvania Ave, Fort Worth, TX 76104-2224 2011-12-05
1467744979 Phyllis S Moore Clinical Nurse Specialist 940 Belmont St, Mclean Hospital Southeast Location, Brockton, MA 02301-5596 2011-05-03
1164657706 Phyllis Moore Licensed Practical Nurse 2250 Hickory Rd, Plymouth Meeting, PA 19462-1047 2009-05-27
1528125747 Phyllis Jane Moore Nurse Practitioner 1200 El Camino Real, South San Francisco, CA 94080-3208 2007-01-03
1528136744 Phyllis R Moore Social Worker 218 N Washington St, Phyllis R Moore Lcswr, Rome, NY 13440 2006-12-04
1407940604 Phyllis Diane Moore I Physical Therapy Assistant 2710 Trotwood Ave, Columbia, TN 38401-4903 2006-10-03

Office Location

Street Address 100 MALLARD CREEK RD
SUITE 406
City LOUISVILLE
State KY
Zip Code 40207-4194

Providers in the same location

NPI Name Taxonomy Address Enumeration
1285622779 Cardiac Care Center of Louisville, Pllc Internal Medicine 100 Mallard Creek Rd, Suite 150, Louisville, KY 40207-4194 2005-10-10
1104213388 Chad C Lanphear Anesthesiologist Assistant 100 Mallard Creek Rd, Louisville, KY 40207-4194 2015-04-24
1598163958 Paige Faye Eggers Registered Nurse 100 Mallard Creek Rd, Suite 320, Louisville, KY 40207-4194 2014-12-16
1407271562 Brittney Leigh Porter Registered Nurse 100 Mallard Creek Rd, Suite 320, Louisville, KY 40207-4194 2014-02-26
1548691876 Heath Webb Perkins Registered Nurse 100 Mallard Creek Rd, Suite 320, Louisville, KY 40207-4194 2013-12-12
1184066474 Alison Elizabeth Hewett Nurse Practitioner 100 Mallard Creek Rd, Ste. 320, Louisville, KY 40207-4194 2013-07-27
1457795734 David J Roach Emergency Medicine 100 Mallard Creek Rd, Suite 406, Louisville, KY 40207-5166 2013-04-17
1831434505 Lori Sexton Specialist/Technologist, Other 100 Mallard Creek Rd, Suite 390, Louisville, KY 40207-4194 2012-12-06
1790020469 Hanna Vaughn Specialist/Technologist, Other 100 Mallard Creek Rd, Suite 390, Louisville, KY 40207-4194 2012-12-06
1639414303 Tina Pennington Specialist/Technologist, Other 100 Mallard Creek Rd, Suite 390, Louisville, KY 40207-4194 2012-12-06
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1780212688 Alexia Louise Bodamer Student in an Organized Health Care Education/Training Program 142 Chenoweth Lane, Lousiville, KY 40207 2020-03-28
1467918664 Amy Rock LLC Counselor 4010 Dupont Cir Ste 307, Louisville, KY 40207 2019-02-13
1649745191 Louisville Optometric Center, IIi, Psc Optometrist 285 Hubbards Lane, Suite 300, Louisville, KY 40207 2018-10-11
1184137440 Crimson Dove Counseling Services Inc Community/Behavioral Health 214 Breckenridge Ln., Suite 203, Louisville, KY 40207 2017-11-09
1285157586 Dickerson Family Enterprise, LLC Non-emergency Medical Transport (VAN) 4350 Brownsboro Rd., Ste. 110, Louisville, KY 40207 2017-07-19
1578085296 Cardiovascular Medical Specialists LLC Surgery 100 Mallard Creek Rd Ste 150, Louisville, KY 40207 2017-07-14
1932636305 Devon Turley Prevention Professional 1017 Dupont Rd, Suite 1, Louisville, KY 40207 2017-05-17
1285095539 Emily Schwartz Crouch Marriage & Family Therapist 4010 Dupont Circle, Suite 582, Louisville, KY 40207 2016-03-15
1306201280 A A and Associates Approved Alcohol/drug Program Counselor 4006 Dutchmans Lane, Louisville, KY 40207 2015-12-21
1629433693 Jewish Hospital and St. Mary's Healthcare, Inc. General Acute Care Hospital 3290 Dutchmans Lane, Louisville, KY 40207 2015-12-17
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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1023618535 Pamela Nicole Kinney Nurse Practitioner 13503 Terrace Creek Dr Apt 203, Louisville, KY 40245-5838 2020-10-26
1457950883 Tetteh Narteh Nurse Practitioner 10200 Linn Station Rd Ste 125, Louisville, KY 40223-3889 2020-10-16
1114525540 Richard A Anane Nurse Practitioner 10200 Linn Station Rd Ste 300, Louisville, KY 40223-3841 2020-10-16
1427656081 Elma Mustic Nurse Practitioner 9714 Boxford Way, Louisville, KY 40242-2305 2020-10-15
1679171318 Cassandra Jane Lee Nurse Practitioner 3416 Imperator Ln Unit 103, Louisville, KY 40245-7752 2020-10-14
1942817762 Merritt Borders Nurse Practitioner 1602 Hunnington Pl Apt 4, Louisville, KY 40220-3771 2020-09-25
1114533536 Lyssa Alexandra Miller Nurse Practitioner 5120 Dixie Hwy Ste 101, Louisville, KY 40216-1775 2020-09-21
1174138713 Paola Cristina Maldonado Nurse Practitioner 14719 Eddington Way Apt 304, Louisville, KY 40245-5581 2020-09-10
1033722525 Bynisha Robertson Nurse Practitioner 5312 Sprigwood Ln, Louisville, KY 40291-1135 2020-08-25
1154931202 Heather M Karem Nurse Practitioner 10207 Hartley Dr, Louisville, KY 40223-2735 2020-08-04
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Competitor

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City LOUISVILLE
Zip Code 40207

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Dataset Information

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.

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