| Md Moore Llc | |
|
1031 Hwy 11n Beattyville KY 41311 | |
| (606) 595-8454 | |
| Not Available |
| Full Name | Md Moore Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1031 Hwy 11n, Beattyville, Kentucky |
| Authorized Official Name and Position | Tanya B Moore (OWNER/CEO) |
| Authorized Official Contact | 6065958454 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Md Moore Llc 1031 Hwy 11n Beattyville KY 41311 Ph: (606) 595-8454 | Md Moore Llc 1031 Hwy 11n Beattyville KY 41311 Ph: (606) 595-8454 |
| NPI Number | 1992422802 |
|---|---|
| Provider Enumeration Date | 10/21/2022 |
| Last Update Date | 11/29/2022 |
| Certification Date | 11/29/2022 |
| Medicare PECOS PAC ID | 6901278258 |
|---|---|
| Medicare Enrollment ID | O20230214001853 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992422802 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Ajita R Singh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932530722 PECOS PAC ID: 0143444661 Enrollment ID: I20140624000165 |
| Provider Name | Michael D Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508327537 PECOS PAC ID: 7719212703 Enrollment ID: I20190712002046 |
| Provider Name | Danielle N Guminski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932851219 PECOS PAC ID: 4981098597 Enrollment ID: I20220224002336 |
| Provider Name | Katilynn Treadway Newnam |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336864404 PECOS PAC ID: 3072982800 Enrollment ID: I20221216001672 |
| Provider Name | Tanya Moore |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1588038129 PECOS PAC ID: 0446622799 Enrollment ID: I20240111004616 |