Mrs Misty Ann Moore, CRNP in Southaven, MS - Medicare Nurse Practitioner

Mrs Misty Ann Moore, CRNP is a medicare enrolled "Nurse Practitioner - Family" in Southaven, Mississippi. Her current practice location is 7585 Clarington Cove, Southaven, Mississippi. You can reach out to her office (for appointments etc.) via phone at (662) 349-0200.

Mrs Misty Ann Moore is licensed to practice in Mississippi (license number R860233) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1063465482.

Contact Information

	Mrs Misty Ann Moore, CRNP
	7585 Clarington Cove, Southaven, MS 38671-2300
	(662) 349-0200
	(662) 349-1666

Map and Direction

Provider's Profile

Full Name	Mrs Misty Ann Moore
Gender	Female
Speciality	Nurse Practitioner - Family
Location	7585 Clarington Cove, Southaven, Mississippi
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1063465482
Provider Enumeration Date: 05/18/2006
Last Update Date: 11/28/2017

Medicare PECOS Information:

PECOS PAC ID: 8628020799
Enrollment ID: I20190417000594

Medical Identifiers

Medical identifiers for Mrs Misty Ann Moore such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1063465482	NPI	-	NPPES
406746100	Medicaid	MD

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	APN11904 (Tennessee)	Secondary
363LF0000X	Nurse Practitioner - Family	R860233 (Mississippi)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mrs Misty Ann Moore allows following entities to bill medicare on her behalf.

Entity Name	Levy Dermatology, Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1508007790 PECOS PAC ID: 9032263538 Enrollment ID: O20090818000680

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Misty Ann Moore is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mrs Misty Ann Moore, CRNP 7585 Clarington Cove, Southaven, MS 38671-1516 Ph: (662) 349-0200	Mrs Misty Ann Moore, CRNP 7585 Clarington Cove, Southaven, MS 38671-2300 Ph: (662) 349-0200

Reviews and Comments

Nurse Practitioner Nurses in Southaven, MS

Ms. Sherlean D Shugars, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2149 Stateline Rd W, Southaven, MS 38671 Phone: 662-342-1112
Penny Marie Holley, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3964 Goodman Rd E Ste 128-129, Southaven, MS 38672 Phone: 662-655-0456 Fax: 662-655-0457
Mrs. Christy Le Anne Egbert, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 122 Airways Pl, Southaven, MS 38671 Phone: 662-349-9990 Fax: 662-349-2620
Misty Burton, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 391 Southcrest Cir, Southaven, MS 38671 Phone: 662-349-2659
Rebecca Holly T Robertson, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 122 Airways Pl, Southaven, MS 38671 Phone: 662-349-9990 Fax: 662-349-2620
Debra Gail Gill, RNC, MSN, WHNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 4892 Briarton Dr, Southaven, MS 38672 Phone: 901-262-0332
Jessica N Brown, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 55 Physicians Ln, Southaven, MS 38671 Phone: 662-655-2136

Mrs Misty Ann Moore, CRNP - Medicare Nurse Practitioner in Southaven, MS