Mr Samuel C Moore, FNP-C - Medicare Nurse Practitioner in Hendersonville, TN

Mr Samuel C Moore, FNP-C is a medicare enrolled "Nurse Practitioner - Family" physician in Hendersonville, Tennessee. His current practice location is 107 Glen Oak Blvd Ste 201b, Hendersonville, Tennessee. You can reach out to his office (for appointments etc.) via phone at (615) 499-4545.

Mr Samuel C Moore is licensed to practice in Tennessee (license number 29580) 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 1659048460.

Contact Information

Mr Samuel C Moore, FNP-C
107 Glen Oak Blvd Ste 201b,
Hendersonville, TN 37075-3000
(615) 499-4545
(615) 499-4546



Physician's Profile

Full NameMr Samuel C Moore
GenderMale
SpecialityNurse Practitioner - Family
Location107 Glen Oak Blvd Ste 201b, Hendersonville, Tennessee
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1659048460
  • Provider Enumeration Date: 08/28/2021
  • Last Update Date: 07/19/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 5294121083
  • Enrollment ID: I20220404001296

Medical Identifiers

Medical identifiers for Mr Samuel C Moore such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1659048460NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine 29580 (Tennessee)Secondary
363LF0000XNurse Practitioner - Family 3016346 (Kentucky)Secondary
363LF0000XNurse Practitioner - Family 29580 (Tennessee)Primary

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 Samuel C Moore allows following entities to bill medicare on his behalf.
Entity NameApp Of Tennessee Ed Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI 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. Mr Samuel C 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 AddressPractice Location Address
Mr Samuel C Moore, FNP-C
3024 Business Park Cir,
Goodlettsville, TN 37072-3132

Ph: (615) 239-2018
Mr Samuel C Moore, FNP-C
107 Glen Oak Blvd Ste 201b,
Hendersonville, TN 37075-3000

Ph: (615) 499-4545

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