Mrs Lacy Moore, FNP is a medicare enrolled "Nurse Practitioner - Family" in Wartrace, Tennessee. She graduated from nursing school in 2009 and has 15 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Carmel Clinic Corporation and her current practice location is
507 Blackman Blvd W, Wartrace, Tennessee. You can reach out to her office (for appointments etc.) via phone at
(931) 389-0600.
Mrs Lacy Moore is licensed to practice in Tennessee (license number 14708) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1457682874.
Provider's Profile
| Full Name | Mrs Lacy Moore |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 15 Years |
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| Location | 507 Blackman Blvd W, Wartrace, Tennessee |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Mrs Lacy Moore graduated from nursing school in 2009
NPI Data:
- NPI Number: 1457682874
- Provider Enumeration Date: 01/25/2010
- Last Update Date: 09/28/2011
Medicare PECOS Information:
- PECOS PAC ID: 7719172279
- Enrollment ID: I20101109001489
Medical Identifiers
Medical identifiers for Mrs Lacy Moore such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1457682874 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | 14708 (Tennessee) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Carmel Clinic Corporation | 6002914355 | 2 |
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. Mrs Lacy Moore allows following entities to bill medicare on her behalf.
| Entity Name | Carmel Clinic Corporation |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1326187980
PECOS PAC ID: 6002914355
Enrollment ID: O20070928000198 |
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| Entity Name | App Of Tennessee Ed Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1003230236
PECOS PAC ID: 8123251766
Enrollment ID: O20140506000159 |
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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. Mrs Lacy 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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Mrs Lacy Moore, FNP
507 Blackman Blvd W,
Wartrace, TN 37183-2210
Ph: (931) 389-0600 | Mrs Lacy Moore, FNP
507 Blackman Blvd W,
Wartrace, TN 37183-2210
Ph: (931) 389-0600 |
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