Shannon Summers Moore, MS, RD is a medicare enrolled "Dietitian, Registered" provider in Ferrum, Virginia. Her current practice location is
180 Ferrum Mountain Rd, Ferrum, Virginia. You can reach out to her office (for appointments etc.) via phone at
(540) 365-4469.
Shannon Summers Moore is licensed to practice in North Carolina (license number L004590) 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 1164807913.
Healthcare Provider's Profile
| Full Name | Shannon Summers Moore |
|---|
| Gender | Female |
|---|
| Speciality | Dietitian, Registered |
|---|
| Location | 180 Ferrum Mountain Rd, Ferrum, Virginia |
|---|
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
|---|
NPI Data:
- NPI Number: 1164807913
- Provider Enumeration Date: 07/22/2015
- Last Update Date: 12/03/2021
Medicare PECOS Information:
- PECOS PAC ID: 8729387337
- Enrollment ID: I20211210000262
Medical Identifiers
Medical identifiers for Shannon Summers Moore such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1164807913 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 133V00000X | Dietitian, Registered | L004590 (North Carolina) | 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. Shannon Summers Moore allows following entities to bill medicare on her behalf.
| Provider Name | Tri Area Community Health |
|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
|---|
| Provider Identifiers | NPI Number: 1346227584
PECOS PAC ID: 6204748296
Enrollment ID: O20040122000969 |
|---|
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. Shannon Summers 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 |
|---|
Shannon Summers Moore, MS, RD
993 Vista Ln,
Hiawassee, GA 30546-3980
Ph: (804) 543-9344 | Shannon Summers Moore, MS, RD
180 Ferrum Mountain Rd,
Ferrum, VA 24088-2939
Ph: (540) 365-4469 |
Reviews and Comments