Phyllis P Moore, DNP,FNP-BC is a medicare enrolled "Nurse Practitioner - Family" in Friendship, Tennessee. She graduated from nursing school in 2011 and has 14 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Fast Pace Medical Clinic Pllc and her current practice location is
600 Main St, Friendship, Tennessee. You can reach out to her office (for appointments etc.) via phone at
(731) 677-3400.
Phyllis P Moore is licensed to practice in Tennessee (license number APN0000016606) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1023374279.
Provider's Profile
| Full Name | Phyllis P Moore |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 14 Years |
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| Location | 600 Main St, Friendship, Tennessee |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Phyllis P Moore graduated from nursing school in 2011
NPI Data:
- NPI Number: 1023374279
- Provider Enumeration Date: 04/02/2012
- Last Update Date: 11/03/2016
Medicare PECOS Information:
- PECOS PAC ID: 2264694165
- Enrollment ID: I20120509000473
Medical Identifiers
Medical identifiers for Phyllis P Moore such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1023374279 | NPI | - | NPPES |
| Q021117 | Medicaid | TN | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | APN0000016606 (Tennessee) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Fast Pace Medical Clinic Pllc | 5395881841 | 680 |
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. Phyllis P Moore allows following entities to bill medicare on her behalf.
| Entity Name | University Of Tennessee |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1780686436
PECOS PAC ID: 3072421213
Enrollment ID: O20031119000671 |
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| Entity Name | Fast Pace Medical Clinic Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1134452865
PECOS PAC ID: 5395881841
Enrollment ID: O20091014000112 |
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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. Phyllis P 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 |
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Phyllis P Moore, DNP,FNP-BC
600 Main St,
Friendship, TN 38034-1999
Ph: (731) 677-3400 | Phyllis P Moore, DNP,FNP-BC
600 Main St,
Friendship, TN 38034-1999
Ph: (731) 677-3400 |
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