DERONNA S MOORE PA
NPI 1487067534
Physician Assistant in Kingsport, TN

Q: What is Deronna Moore's NPI number?

The NPI number for Deronna Moore is 1487067534. It was assigned to this individual provider in the NPPES registry on June 6, 2014.

Q: What is Deronna Moore's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Deronna Moore was last updated on June 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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 June 06, 2014PECOS EnrolledAccepts Medicare Assignment

111 W STONE DR STE 110, KINGSPORT, TN 37660(423) 224-3701 Get Directions Write a Review

NPPES record last updated: June 9, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 9, 2025, Sep 25, 2024 (2 updates tracked since 2024).

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About Deronna S Moore Pa NPPES

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

DERONNA S MOORE PA (NPI 1487067534) is an individual physician assistant in Kingsport, Tennessee, licensed in Tennessee (2543) and active in the NPI registry since June 2014. She is enrolled in Medicare PECOS, is affiliated with Hawkins County Memorial Hospital, and maintains 10 additional practice locations.

NPPES Registry Identity

NPI1487067534

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameDERONNA S MOORECredential: PA

Location Address111 W STONE DR STE 110Kingsport, TN 37660-6027

Mailing Address1021 W Oakland Ave Ste 310Johnson City, TN 37604-2192 · (423) 302-6565

Phone(423) 224-3701

Sole ProprietorNo

Medical School CMSOtherGraduated 2013

Enumeration DateJune 6, 2014

Last NPPES UpdateJune 9, 20252 updates tracked since enumeration

NPPES CertifiedJune 9, 2025

✔ NPI 1487067534 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

Licenses✔ Licensed in TN · 2543✔ Licensed in VA · 0110009681✔ Licensed in KY · 1903

Definition

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.

111 W STONE DR STE 110, Kingsport, TN 37660

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Secondary Practice Locations 10

Location 11497 W Elk Ave Ste 11Elizabethton, TN 37643-2896 · Phone (423) 542-8929

Location 24600 Fort Henry DrKingsport, TN 37663-2617 · Phone (423) 224-3950

Location 3115 Judge Gresham Rd Ste AGray, TN 37615-6213 · Phone (423) 467-3000

Location 424530 Falcon Place Blvd Ste 100Abingdon, VA 24211-7665 · Phone (276) 619-0075

Location 51220 Volunteer PkwyBristol, TN 37620-4628 · Phone (423) 274-6610

Location 6405 Scenic Dr Ste ARogersville, TN 37857-2441 · Phone (423) 921-3490

Location 7438 E Vann Rd Ste 301Greeneville, TN 37743-7202 · Phone (423) 636-9828

Location 82686 W State StBristol, TN 37620-1817 · Phone (423) 844-0026

Location 9161 Heart Dr Ste AJohnson City, TN 37604-2607 · Phone (423) 282-0751

Location 10231 S Fairmont AveMorristown, TN 37813-2036 · Phone (423) 839-1600

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BlueCross BlueShield of Tennessee.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

Deronna S Moore Pa 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 ID9335366483

PECOS Enrollment IDI20141006002347

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.

Areas of Expertise CMS Part B claims 9

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Injection, dexamethasone sodium phosphate, 1 mg J1100

Dexamethasone sodium phosphate is a medication given via injection. It is a type of steroid that helps reduce inflammation and immune responses. It can be used to treat a variety of conditions, such as allergies, skin conditions, arthritis, and more.

155 services17 patients

Injection, ceftriaxone sodium, per 250 mg J0696

Ceftriaxone sodium is an antibiotic injection used to treat a variety of bacterial infections. Each injection contains 250 mg of the medicine. It works by stopping the growth of bacteria in your body.

92 services21 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

78 services76 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

47 services37 patients

Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen 87635

This is a lab test that detects the presence of COVID-19 in your body. It uses a technique to amplify the virus's genetic material, either DNA or RNA, making it easier to identify. A positive result indicates an active infection.

37 services36 patients

Detection test by nucleic acid for multiple types influenza virus 87502

A detection test by nucleic acid for multiple types of influenza virus is a diagnostic procedure. It identifies the genetic material of the virus in your body. It's highly accurate and can distinguish between different flu strains, helping in prompt and precise treatment.

25 services25 patients

Hospital Affiliations CMS Care Compare 2

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

Hawkins County Memorial Hospital

Acute Care Hospitals · Rogersville, TN

OwnershipVoluntary non-profit - Private

CMS Certification Number440032

Location851 Locust StreetRogersville, TN 37857 · Hawkins County

Emergency services

Greeneville Community Hospital

Acute Care Hospitals · Greeneville, TN

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number440050

Location1420 Tusculum BoulevardGreeneville, TN 37745 · Greene County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37660 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

$81.53 typical visit price

range $52.64 – $160.89

Typical copayment $20.38 (range $13.16 – $40.22)

Most-billed visit code 99203

Established Patient

$66.01 typical visit price

range $16.72 – $131.41

Typical copayment $16.50 (range $4.18 – $32.85)

Most-billed visit code 99213

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

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

2 suppliers72 claims73 services$4.24 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

MRS. AMANDA SUSAN BURNS ARNP

Nurse Practitioner