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Deactivated NPI 1831207117 Deactivated / Inactive NPI Male Practitioner

Dr. Kerry F Moore , MD

General Practice • North Tazewell, VA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Kerry Moore has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date August 28, 2006
NPI Deactivation Date September 09, 2019
Total Practice Duration ~13 Years of Practice (2006 – 2019)

Professional Overview & Biography Verified Profile Summary

Dr. Kerry Moore, MD was a registered General Practice practicing in North Tazewell, VA. Throughout an active medical career spanning 13 years, Dr. Moore provided care at the practice location at 583C E RIVERSIDE DR until profile deactivation on 2019-09-09.

Historical Medicare Part B clinical services included hemoglobin a1c level, insertion of needle into vein for collection of blood sample. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

583c E Riverside Dr

North Tazewell, VA 246309573

Telephone 2769799899
Fax 2769799798
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for General Practice in North Tazewell, VA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 24.0 Yrs
Regional Practice Density
1 Specialists

Practicing in North Tazewell, VA (440 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
85.9% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2018)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
83036 Hemoglobin A1C level
43 33 $83.07 $11.75

Medical Specialties & State Licenses

General Practice Primary Specialty

NUCC Taxonomy Code: 208D00000X

State License VA 0101240861

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

11 Associated Practitioners
Susan Horne , NP

Nurse Practitioner - Family

NPI 1003587338

Nurse Practitioner

Marie Green , NP

Nurse Practitioner

NPI 1215549936

Nurse Practitioner

Baylee Rose

Counselor - Addiction (Substance Use Disorder)

NPI 1245164235
Katie Newsome-Deel , APRN

Nurse Practitioner - Family

NPI 1255752861

Advanced Practice Registered Nurse

Deborah Ball , FNP

Nurse Practitioner - Family

NPI 1407969017

Family Nurse Practitioner

NPI 1508271818

Doctor of Dental Surgery

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated September 09, 2019

Record deactivated on September 09, 2019

NPI Profile Active October 17, 2014

NPI status registered as active in NPPES database

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Updated Practice Location October 17, 2014

Registered at 583C E RIVERSIDE DR, NORTH TAZEWELL, VA 246309573 (Tel: 2769799899)

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Updated Business Mailing Address October 17, 2014

Registered at 583C E RIVERSIDE DR, NORTH TAZEWELL, VA 246309573 (Tel: 2769799899)

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Provider Name / Credentials Updated October 17, 2014

Recorded as KERRY MOORE, MD

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Medical Taxonomy / Specialty Registered (Primary Specialty) October 17, 2014

General Practice (License #0101240861 in VA)

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Initial NPI Registration & Enumeration August 28, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1831207117
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 28, 2006
Last Update: October 17, 2014
Deactivation Date: September 09, 2019

Mailing Address

583c E Riverside Dr

North Tazewell, VA 246309573

Phone: 2769799899

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.