MR. MARK MOORE (NPI# 1962489567) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962489567 |
| Entity Type | Individual |
| Full Name | MR. MARK MOORE |
| Credential | CFNP |
| Practice Address |
1600 22nd Ave Medical Towers IIi Meridian MS 39301-3223 |
| Practice Telephone | 6014835322 |
| Practice Fax Number | 6015812289 |
| Mailing Telephone | 6014835322 |
| Mailing Fax Number | 6015812289 |
| Enumeration Date | 2005-12-27 |
| Last Update Date | 2011-06-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | R669059 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 02904207 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073031019 | Mark Daniel Moore | Psychologist | 100 Miner St, Crescent City, IL 60928-8092 | 2017-08-30 |
| 1114462017 | Mark Christopher Moore | Anesthesiologist Assistant | 8000 E Maplewood Ave Bldg 5, Ste. 200, Greenwood Village, CO 80111-4766 | 2016-12-30 |
| 1699981183 | Mark Wayne Moore | Dentist | 2301 12th St, Meridian, MS 39301-3934 | 2007-05-14 |
| 1588747588 | Mark W Moore | Physical Therapist | 6036 N 19th Ave Ste 303, Phoenix, AZ 85015 | 2006-10-23 |
| 1346338530 | Mark Douglas Moore | Optometrist | 2020 N Tyler Rd Ste 124, Wichita, KS 67212-4916 | 2006-10-11 |
| 1730289935 | Mark Edward Moore | Optometrist | 3333 S Crater Rd Ste 2d, Petersburg, VA 23805-9276 | 2006-09-25 |
| 1043328800 | Mark D Moore | Optometrist | 504 Peterson Ave S, Douglas, GA 31533-5254 | 2006-08-29 |
| 1104934462 | Mark Stephen Moore | Dentist | 5501 Matlock Rd, Arlington, TX 76018-1534 | 2006-08-28 |
| 1225022833 | Mark Phillip Moore | Dentist | 2048 Windward Ln, Gainesville, GA 30501-7418 | 2005-09-09 |
| 1710527130 | Mark Moore | Community Health Worker | 1114 Lane 12, Lovell, WY 82431-9555 | 2020-01-14 |
| Street Address |
1600 22ND AVE MEDICAL TOWERS III |
| City | MERIDIAN |
| State | MS |
| Zip Code | 39301-3223 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609867209 | Joel Charles Reynolds | Internal Medicine | 1600 22nd Ave, Meridian, MS 39301-3223 | 2005-11-02 |
| 1730671538 | Erin Cooley | Nurse Practitioner | 1600 22nd Ave, Meridian, MS 39301-3223 | 2018-06-06 |
| 1043662851 | Sarah Neely Ivey | Nurse Practitioner | 1600 22nd Ave, Meridian, MS 39301-3223 | 2016-07-05 |
| 1114399375 | Brandi L Robinson | Nurse Practitioner | 1600 22nd Ave, Meridian, MS 39301-3223 | 2015-10-28 |
| 1710227905 | Casey Tillery | Nurse Practitioner | 1600 22nd Ave, Medical Towers IIi, Meridian, MS 39301-3223 | 2013-02-25 |
| 1760627111 | Jessica T Meyer | Nurse Practitioner | 1600 22nd Ave, Medical Towers IIi, Meridian, MS 39301-3223 | 2008-12-12 |
| 1396980116 | Valerie Nicole Evans | Family Medicine | 1600 22nd Ave, Meridian, MS 39301-3223 | 2008-12-08 |
| 1396927448 | Attila Roka | Internal Medicine | 1600 22nd Ave, Meridian, MS 39301-3223 | 2007-11-30 |
| 1225232895 | Larry Shea Shea Hailey | Internal Medicine | 1600 22nd Ave, Medical Towers IIi, Meridian, MS 39301-3223 | 2007-06-14 |
| 1346466596 | Eric Vincent Plott | Internal Medicine | 1600 22nd Ave, Meridian, MS 39301-3223 | 2007-04-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407460439 | Kayla Lee Monsour | Pharmacist | 1415 24th Avenue, Meridian, MS 39301 | 2020-09-08 |
| 1306478359 | K&r Optical Solutions Corporation | Eyewear Supplier (Equipment, not the service) | 3126 8th St., Suite A, Meridian, MS 39301 | 2020-02-07 |
| 1912537317 | Courtney M Hollie | Counselor | 1054 Ms-19, Meridian, MS 39301 | 2020-01-24 |
| 1932636495 | Rcg Mississippi, Inc. | Clinic/Center | 1300 38th Ave E, Meridian, MS 39301 | 2017-05-16 |
| 1811428915 | Tierria Mcglothin | Nurse Practitioner | 1054 Highway 19 S, Meridian, MS 39301 | 2017-03-21 |
| 1154869303 | Lindsay Nemanich | Physical Therapist | 3716 Ms-39, Meridian, MS 39301 | 2017-02-08 |
| 1700323599 | Wal-mart Stores East Lp | Pharmacy | 3310-a Highway 39 North, Meridian, MS 39301 | 2017-01-31 |
| 1972977460 | Southeast Pharmacy LLC | Pharmacy | 2402 Long Creek Road, Meridian, MS 39301 | 2015-11-20 |
| 1235508342 | East Mississippi Oral & Facial Surgery, LLC | Clinic/Center | 1212 24th Avenue, Meridian, MS 39301 | 2015-09-18 |
| 1831580778 | Clarkdale Pharmacy and Gifts LLC | Pharmacy | 6935c Hwy 145, Meridian, MS 39301 | 2015-02-13 |
| Find all providers in zip 39301 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164043162 | Slavik Osipchuk | Nurse Practitioner | 2329 W Root Creek St, Meridian, ID 83646-4678 | 2020-04-30 |
| 1760025639 | Kimberly Watson | Nurse Practitioner | 3536 W Moon Lake St, Meridian, ID 83646-8304 | 2019-10-23 |
| 1649824277 | Bryana Michel Hinck | Nurse Practitioner | 150 W Broderick Dr, Meridian, ID 83646-0009 | 2019-07-31 |
| 1457846206 | Teri Ann Meadows | Nurse Practitioner | 520 S Eagle Rd Ste 3211, Meridian, ID 83642-6356 | 2018-06-25 |
| 1871017855 | Robbyn Lee | Nurse Practitioner | 4715 24th Place, Meridian, MS 39305 | 2017-08-01 |
| 1326584640 | Kyle Joseph Ronnau | Nurse Practitioner | 1672 S Woodsage Avenue, Suite #120, Meridian, ID 83642 | 2017-01-10 |
| 1720522436 | Jennifer Robinson | Nurse Practitioner | 2985 S Meridian Rd Ste 100, Meridian, ID 83642-8051 | 2016-12-14 |
| 1366733164 | Erica Glover | Nurse Practitioner | 10641 Highway 80 W, Meridian, MS 39307-9256 | 2011-04-27 |
| 1568545556 | Angela Mcdonald | Nurse Practitioner | Nbhc Meridian 1801 Fuller St Bldg 367, Meridian, MS 39309-3107 | 2006-10-23 |
| 1275631244 | Cherese R Tarter | Nurse Practitioner | 1560 N Crestmont Dr Ste A, Meridian, ID 83642-2178 | 2006-09-21 |
| Find all providers in MERIDIAN | ||||
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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.