Phyllis P Moore, DNP,FNP-BC is a medicare enrolled "Nurse Practitioner - Family" in Friendship, Tennessee. 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 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 1023374279.
Provider's Profile
Full Name | Phyllis P Moore |
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Gender | Female |
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Speciality | Nurse Practitioner - Family |
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Location | 600 Main St, Friendship, Tennessee |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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 |
363LF0000X | Nurse Practitioner - Family | APN0000016606 (Tennessee) | 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. 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 |
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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