PAMELA M MOORE NP NPI 1881701308

NPI Information

NPI: 1881701308
Provider Name: PAMELA M MOORE, NP
Classification: Nurse Practitioner - 363LA2200X
Entity Type: Individual

Specialization: Adult Health

PECOS Registration: Yes

Address:
611 W. PARK ST.
CARDIOLOGY
URBANA, IL
ZIP 61801
Phone: (217) 904-7000
Get Directions

Pamela M Moore, NP is an adult health nurse practitioner in Urbana, IL with 27 years of experience. Pamela M Moore, NP NPI is 1881701308. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

611 W. PARK ST.
CARDIOLOGY
URBANA, IL
ZIP 61801-500
Phone: (217) 904-7000
Fax: (217) 904-7742

The NPI 1881701308 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/23/2006 and was last updated on 5/28/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2086S0129X	Surgery	Vascular Surgery	RN81005	ARIZONA	No
2	363LA2200X	Nurse Practitioner	Adult Health	209-006880	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	103086	OTHER	ARIZONA	RR MC PIN
2	300051634	OTHER		CIGNA
3	103087	MEDICARE ID-TYPE UNSPECIFIED	ARIZONA
4	102542	OTHER	ARIZONA	RR MC GRP
5	103086	OTHER		MC COCHISE
6	1Z1408	OTHER		INTERGROUP HEALTHNET
7	448664	OTHER		AHCCCS
8	S54711	MEDICARE UPIN
9	AZ0819900	OTHER	ARIZONA	BCBS
10	448664	OTHER		MERCY CARE
11	300051634	OTHER		AETNA
12	500005593	OTHER		TRAVELERS MC
13	448664	OTHER		INDIAN HEALTH
14	103087	OTHER	ARIZONA	RR MC PIN
15	300051634	OTHER	ARIZONA	HEALTH PLAN AHP
16	448664	MEDICAID	ARIZONA
17	300051634	OTHER		HUMANA
18	300051634	OTHER		MARICOPA FOUND
19	IL3270596	MEDICARE PIN	ILLINOIS
20	103087	OTHER		MC PIMA
21	103086	MEDICARE ID-TYPE UNSPECIFIED	ARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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