BRAD EDWARD MOORE NP
NPI 1578094207
Nurse Practitioner - Family in Johnson City, TN

Q: What is Brad Moore's NPI number?

The NPI number for Brad Moore is 1578094207. It was assigned to this individual provider in the NPPES registry on March 24, 2017. The provider is also known as Brad E Moore.

Q: What is Brad 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 Brad Moore was last updated on May 20, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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 March 24, 2017PECOS EnrolledAccepts Medicare Assignment

301 MED TECH PKWY STE 240, JOHNSON CITY, TN 37604(423) 794-5520(423) 282-6940 Get Directions Write a Review

NPPES record last updated: May 20, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 20, 2026, Mar 3, 2025, May 23, 2022 and 2 more (5 updates tracked since 2017).

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About Brad Edward Moore Np NPPES

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

BRAD EDWARD MOORE NP (NPI 1578094207) is an individual family provider in Johnson City, Tennessee, licensed in Tennessee (22515) and active in the NPI registry since March 2017. He is enrolled in Medicare PECOS, is affiliated with Wellmont Bristol Regional Medical Center, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1578094207

Entity TypeIndividualMale

Primary Taxonomy363LF0000X

Provider Legal NameBRAD EDWARD MOORECredential: NP

Location Address301 MED TECH PKWY STE 240Johnson City, TN 37604-2641

Mailing AddressPo Box 632476Cincinnati, OH 45263-2476 · (423) 794-5520 · Fax (234) 283-9480

Phone(423) 794-5520

Fax(423) 282-6940

Sole ProprietorNo

Medical School CMSOtherGraduated 2016

Enumeration DateMarch 24, 2017

Last NPPES UpdateMay 20, 20265 updates tracked since enumeration

NPPES CertifiedMay 20, 2026

✔ NPI 1578094207 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

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

Taxonomy Code363LF0000X

License✔ Licensed in TN · 22515

Also ListedRegistered NurseTaxonomy 163W00000X · License 194218 (TN)

301 MED TECH PKWY STE 240, Johnson City, TN 37604

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Other Names 1

Other Name (5)Brad E Moore

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

Brad Edward Moore Np 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 ID6800173097

PECOS Enrollment IDI20170425001538

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 2

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.

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

81 services79 patients

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

19 services17 patients

Hospital Affiliations CMS Care Compare 4

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

Wellmont Bristol Regional Medical Center

Acute Care Hospitals · Bristol, TN

1/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number440012

LocationOne Medical Park BlvdBristol, TN 37620 · Sullivan County

Emergency services Birthing friendly

Wellmont Holston Valley Medical Center

Acute Care Hospitals · Kingsport, TN

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number440017

Location130 West Ravine RoadKingsport, TN 37662 · Sullivan County

Emergency services

Johnson City Medical Center

Acute Care Hospitals · Johnson City, TN

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number440063

Location400 N State Of Franklin RdJohnson City, TN 37604 · Washington County

Emergency services Birthing friendly

Indian Path Community Hospital

Acute Care Hospitals · Kingsport, TN

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number440176

Location2000 Brookside DrKingsport, TN 37660 · Sullivan County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37604 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

$93.60 typical visit price

range $16.72 – $131.41

Typical copayment $23.40 (range $4.18 – $32.85)

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 20

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

ELIZABETH A PETTEY NP

Nurse Practitioner