Mr Colton Ray Moore, APRN, FNP-C is a medicare enrolled "Family Medicine" in Union City, Tennessee. He graduated from nursing school in 2020 and has 4 years of diverse experience with area of expertise as Nurse Practitioner. He is a member of the group practice Emergency Medical Care Facilities Pc and his current practice location is
1720 E Reelfoot Ave Ste 200, Union City, Tennessee. You can reach out to his office (for appointments etc.) via phone at
(901) 350-0978.
Mr Colton Ray Moore is licensed to practice in Tennessee (license number 27851) and he also participates in the medicare program. He
may accept medicare assignments (which means he may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and his NPI Number is 1821607052.
Provider's Profile
| Full Name | Mr Colton Ray Moore |
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| Gender | Male |
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| Speciality | Nurse Practitioner |
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| Experience | 4 Years |
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| Location | 1720 E Reelfoot Ave Ste 200, Union City, Tennessee |
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| Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Mr Colton Ray Moore graduated from nursing school in 2020
NPI Data:
- NPI Number: 1821607052
- Provider Enumeration Date: 07/23/2020
- Last Update Date: 03/08/2024
Medicare PECOS Information:
- PECOS PAC ID: 0941627814
- Enrollment ID: I20200825000269
Medical Identifiers
Medical identifiers for Mr Colton Ray Moore such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1821607052 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | 27851 (Tennessee) | Secondary |
| 207Q00000X | Family Medicine | 27851 (Tennessee) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Emergency Medical Care Facilities Pc | 6103837877 | 30 |
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. Mr Colton Ray Moore allows following entities to bill medicare on his behalf.
| Entity Name | Emergency Medical Care Facilities Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1538345855
PECOS PAC ID: 6103837877
Enrollment ID: O20060509000565 |
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| Entity Name | Southern Pain And Regenerative Medicine Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1841799707
PECOS PAC ID: 2769733377
Enrollment ID: O20180920002187 |
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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. Mr Colton Ray 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 |
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Mr Colton Ray Moore, APRN, FNP-C
1720 E Reelfoot Ave Ste 200,
Union City, TN 38261-6049
Ph: (901) 350-0978 | Mr Colton Ray Moore, APRN, FNP-C
1720 E Reelfoot Ave Ste 200,
Union City, TN 38261-6049
Ph: (901) 350-0978 |
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