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MARY MOORE CRNA
NPI 1912010166
Nurse Anesthetist, Certified Registered in Big Stone Gap, VA

Active since August 15, 2006
1980 HOLTON AVE E, BIG STONE GAP, VA 24219(276) 523-3111 Get Directions Write a Review

NPPES record last updated: November 29, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mary Moore Crna NPPES

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

MARY MOORE CRNA (NPI 1912010166) is an individual nurse anesthetist, certified registered in Big Stone Gap, Virginia, licensed in Virginia (0024049167) and active in the NPI registry since August 2006.

NPPES Registry Identity

NPI1912010166
Entity TypeIndividualFemale
Primary Taxonomy367500000X
Provider Legal NameMARY MOORECredential: CRNA
Location Address1980 HOLTON AVE EBig Stone Gap, VA 24219-3366
Mailing Address999 Executive Park Blvd, Suite 201Kingsport, TN 37660-4632 · (423) 224-3250 · Fax (423) 224-3258
Phone(276) 523-3111
Sole ProprietorNo
Enumeration DateAugust 15, 2006
Last NPPES UpdateNovember 29, 2007
✔ NPI 1912010166 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367500000X
License✔ Licensed in VA · 0024049167
Definition
(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.
1980 HOLTON AVE E, Big Stone Gap, VA 24219
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Other Identifiers 2

Medicaid74012436KY
Medicare PIN010257W82VA

Other Providers at the Same Location NPPES 7

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

DR. EDAKANDYIL MANOHARAN MD
Obstetrics & Gynecology
1980 HOLTON AVE E, SUITE 301
BIG STONE GAP, VA 24219
Wise County (276) 523-0390
WELLMONT PHYSICIAN SERVICES INC
Obstetrics & Gynecology
1980 HOLTON AVE E, SUITE 301
BIG STONE GAP, VA 24219
Wise County (276) 523-0390
PULMONARY ASSOCIATES OF KINGSPORT
Specialist
1980 HOLTON AVE E, SUITE 202
BIG STONE GAP, VA 24219
Wise County (276) 523-8860
PROF. MICHAEL C VACCO MD
Pediatrics
1980 HOLTON AVE E, SUITE 203
BIG STONE GAP, VA 24219
Wise County (276) 523-8681
JOSEPH W FRYE II D.O.
Physical Medicine & Rehabilitation
1980 HOLTON AVE E, SUITE 202
BIG STONE GAP, VA 24219
Wise County (276) 523-8973
LAWRENCE J. FLEENOR JR
Family Medicine
1980 HOLTON AVE E
BIG STONE GAP, VA 24219
Wise County (276) 523-1600
WELLMONT PHYSICIAN SERVICES INC
Family Medicine
1980 HOLTON AVE E
BIG STONE GAP, VA 24219
Wise County (276) 523-8741

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mary Moore's NPI number?

The NPI number for Mary Moore is 1912010166. It was assigned to this individual provider in the NPPES registry on August 15, 2006.

Where is Mary Moore located?

Mary Moore practices at 1980 Holton Ave E, Big Stone Gap, VA 24219. The listed phone number is (276) 523-3111.

What is Mary Moore's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

When was this NPI record last updated?

The NPPES record for Mary Moore was last updated on November 29, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years 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.