John Thomas Moore, PA-C is a medicare enrolled "Physician Assistant" in La Grange, North Carolina. His current practice location is
2154 Sutton Hooten Ln, La Grange, North Carolina. You can reach out to his office (for appointments etc.) via phone at
(252) 566-3298.
John Thomas Moore is licensed to practice in North Carolina (license number 100460) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1508850983.
Provider's Profile
Full Name | John Thomas Moore |
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Gender | Male |
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Speciality | Physician Assistant |
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Location | 2154 Sutton Hooten Ln, La Grange, North Carolina |
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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: 1508850983
- Provider Enumeration Date: 08/31/2005
- Last Update Date: 02/17/2010
Medicare PECOS Information:
- PECOS PAC ID: 7315983244
- Enrollment ID: I20050630000936
Medical Identifiers
Medical identifiers for John Thomas Moore such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1508850983 | NPI | - | NPPES |
2335762 | Other | NC | MEDICARE GROUP PROVIDER NUMBER |
2763714A | Other | NC | MEDICARE INDIVIDUAL PROVIDER NUMBER |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363A00000X | Physician Assistant | 100460 (North Carolina) | Primary |
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. John Thomas 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 |
John Thomas Moore, PA-C 2154 Sutton Hooten Ln, La Grange, NC 28551-8252 Ph: (252) 521-2957 | John Thomas Moore, PA-C 2154 Sutton Hooten Ln, La Grange, NC 28551-8252 Ph: (252) 566-3298 |
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