GLORIA L MOORE FNP
NPI 1073235859
Nurse Practitioner - Family in Southfield, MI

Q: What is Gloria Moore's NPI number?

The NPI number for Gloria Moore is 1073235859. It was assigned to this individual provider in the NPPES registry on September 19, 2022.

Q: What is Gloria Moore's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Gloria Moore was last updated on April 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 19, 2022PECOS EnrolledAccepts Medicare Assignment

18000 W 9 MILE RD STE 525, SOUTHFIELD, MI 48075(248) 327-6196(877) 311-5596 Get Directions Write a Review

NPPES record last updated: April 6, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 6, 2026, Nov 6, 2024, Nov 12, 2023 and 3 more (6 updates tracked since 2022).

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About Gloria L Moore Fnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GLORIA L MOORE FNP (NPI 1073235859) is an individual family provider in Southfield, Michigan, licensed in Michigan (4704301246NSA220SA) and active in the NPI registry since September 2022. She is enrolled in Medicare PECOS, is affiliated with Lake Huron Medical Center, and maintains 3 additional practice locations.

NPPES Registry Identity

NPI1073235859

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameGLORIA L MOORECredential: FNP

Location Address18000 W 9 MILE RD STE 525Southfield, MI 48075-4080

Mailing Address5316 Lakeshore RdFort Gratiot, MI 48059-3118 · (810) 357-8792 · Fax (810) 512-7725

Phone(248) 327-6196

Fax(877) 311-5596

Sole ProprietorNo

Medical School CMSUniversity Of Michigan Medical SchoolGraduated 2020

Enumeration DateSeptember 19, 2022

Last NPPES UpdateApril 6, 20266 updates tracked since enumeration

NPPES CertifiedApril 6, 2026

✔ NPI 1073235859 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 9

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in MI · 4704301246NSA220SA

Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X

Also ListedCounselor · Mental HealthTaxonomy 101YM0800X

Also ListedCounselor · ProfessionalTaxonomy 101YP2500X

Also ListedSocial Worker · ClinicalTaxonomy 1041C0700X

Also ListedRegistered Nurse · Wound CareTaxonomy 163WW0000X · License 4704263386 (MI)

Also ListedRegistered Nurse · Ostomy CareTaxonomy 163WX1500X · License 4704263386 (MI)

Also ListedPhysical Therapy AssistantTaxonomy 225200000X

Also ListedNurse Practitioner · Primary CareTaxonomy 363LP2300X · License 4704263386 (MI)

18000 W 9 MILE RD STE 525, Southfield, MI 48075

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Secondary Practice Locations 3

Location 11530 Pine Grove Ave Ste 1Port Huron, MI 48060-3370 · Phone (810) 357-8769

Location 25316 Lakeshore RdFort Gratiot, MI 48059-3118 · Phone (810) 357-8792 · Fax (810) 512-7725

Location 32601 Electric AvePort Huron, MI 48060-6587 · Phone (810) 216-1500

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Priority Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Gloria L Moore Fnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4284089574

PECOS Enrollment IDI20231005003016

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Lake Huron Medical Center

Acute Care Hospitals · Port Huron, MI

4/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number230031

Location2601 Electric AvenuePort Huron, MI 48060 · St. Clair County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48075 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$90.76 typical visit price

range $58.04 – $177.36

Typical copayment $22.69 (range $14.51 – $44.34)

Most-billed visit code 99203

Established Patient

$102.35 typical visit price

range $18.32 – $143.49

Typical copayment $25.58 (range $4.58 – $35.87)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SUSAN PETERSON

Nurse Practitioner (Primary Care)