MRS. PAMELA J MOORE CPNP NPI 1306846142

NPI Information

  • NPI: 1306846142
  • Provider Name: MRS. PAMELA J MOORE, CPNP
  • Classification: Nurse Practitioner - 363LP0200X
  • Specialization: Pediatrics
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1000 PINE STREET
    VARNVILLE, SC
    ZIP 29944
  • Phone: (803) 943-5228

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NPI Details

MRS. Pamela J Moore, CPNP is a pediatrics nurse practitioner in Varnville, SC. MRS. Pamela J Moore, CPNP NPI is 1306846142. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1000 PINE STREET
VARNVILLE, SC
ZIP 29944-969
Phone: (803) 943-5228
Fax: (803) 943-4591

The NPI 1306846142 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/22/2005 and was last updated on 6/24/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0200XNurse PractitionerPediatrics1881SOUTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
14004MEDICARE PINSOUTH CAROLINA
2570669239OTHERSOUTH CAROLINAFED TIN NUMBER
3GP0365MEDICAIDSOUTH CAROLINA
4423820MEDICARE OSCAR/CERTIFICATIONSOUTH CAROLINA
5RHC013MEDICAIDSOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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