BEVERLY DAWN MOOSE MD NPI 1487747648

NPI Information

NPI: 1487747648
Provider Name: BEVERLY DAWN MOOSE, MD
Classification: Radiology - 2085R0001X
Entity Type: Individual

Specialization: Radiation Oncology

PECOS Registration: Yes

Address:
3333 SILAS CREEK PKWY
WINSTON SALEM, NC
ZIP 27103
Phone: (336) 718-5095
Get Directions

Beverly Dawn Moose, MD is a radiation oncology radiology in Winston Salem, NC. The provider is a radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. Beverly Dawn Moose, MD NPI is 1487747648. 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:

3333 SILAS CREEK PKWY
WINSTON SALEM, NC
ZIP 27103-013
Phone: (336) 718-5095
Fax: (336) 718-9895

The NPI 1487747648 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 10/2/2006 and was last updated on 12/11/2012.

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
1	2085R0001X	Radiology	Radiation Oncology	96-00124	NORTH CAROLINA	Yes

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
1	2408394	OTHER		UNITED HEALTH CARE
2	60531	OTHER	NORTH CAROLINA	BLUE CROSS/BLUE SHIELD
3	13799	OTHER		PARTNERS NATIONAL HEALTH
4	6760232005	OTHER		CIGNA HEALTH CARE
5	8960531	MEDICAID	NORTH CAROLINA
6	920005728	MEDICARE ID-TYPE UNSPECIFIED		RAILROAD
7	97953	OTHER		MEDCOST
8	F81327	MEDICARE UPIN
9	5860531	MEDICAID	VIRGINIA
10	2222211A	MEDICARE ID-TYPE UNSPECIFIED

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: 4/28/2024

NPI Synchronization or Removal

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