Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Brad Edward Moore, NP

Individual provider Registered Nurse · NPI 1578094207

Brad Edward Moore, NP is a Nurse Practitioner in Johnson City, Tennessee. Qualified in 2016, 10 years ago. Practices with Tusculum Physician Services PC, a 32-clinician group and accepts Medicare assignment. Licensed in Tennessee.

Years since qualifying
10
Licensed in
TN
In the registry since
2017
Specialties on file
2
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

301 Med Tech Pkwy Ste 240
Johnson City, TN 37604-2641
Phone: (423) 794-5520
Fax: (423) 282-6940
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 22515 (TN)
Registered Nurse Taxonomy 163W00000X · Licence 194218 (TN)

Record details

NPI number1578094207
Entity typeIndividual (Type 1)
GenderMale
Credentials NP
Sole proprietorNo
NPI enumeratedMarch 24, 2017
Last updated in NPPESMay 20, 2026
Certification dateMay 20, 2026
Mailing addressPo Box 632476, Cincinnati, OH 45263-2476

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Tusculum Physician Services Pc — 32 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Johnson City