DERONNA S MOORE PA NPI 1487067534

NPI Information

  • NPI: 1487067534
  • Provider Name: DERONNA S MOORE, PA
  • Classification: Physician Assistant - 363A00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 111 W STONE DR STE 110
    KINGSPORT, TN
    ZIP 37660
  • Phone: (423) 224-3701

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NPI Details

Deronna S Moore, PA is a physician assistant in Kingsport, TN with 13 years of experience. The provider is a physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. Deronna S Moore, PA NPI is 1487067534. 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:

111 W STONE DR STE 110
KINGSPORT, TN
ZIP 37660-027
Phone: (423) 224-3701

The NPI 1487067534 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 following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Injection, dexamethasone sodium phosphate, 1 mg (HCPCS:J1100)
  • Detection test by immunoassay with direct visual observation for influenza virus (HCPCS:87804)
  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Injection, ceftriaxone sodium, per 250 mg (HCPCS:J0696)
  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen (HCPCS:87635)
  • Injection of drug or substance under skin or into muscle (HCPCS:96372)
  • New patient office or other outpatient visit, 30-44 minutes (HCPCS:99203)
  • Automated urinalysis test (HCPCS:81003)
  • Respiratory infectious agent detection by rna for severe acute respiratory syndrome coronavirus 2 (covid 19), influenza a, influenza b, and respiratory syncytial virus, upper respiratory specimen, each reported as detected or not detected (HCPCS:0241U)
  • X-ray of chest, 2 views (HCPCS:71046)

The enumeration date for this NPI number is 6/6/2014 and was last updated on 6/9/2025.

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
1363A00000XPhysician Assistant0110009681VIRGINIANo
2363A00000XPhysician Assistant1903KENTUCKYNo
3363A00000XPhysician Assistant2543TENNESSEEYes

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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