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

Deronna S Moore, PA

Individual provider Physician Assistant · NPI 1487067534

Deronna S Moore, PA is a Physician Assistant in Kingsport, Tennessee. Qualified in 2013, 13 years ago. Practices with Wellmont Medical Associates Inc, a 435-clinician group, works from 11 locations and accepts Medicare assignment. Licensed in Kentucky, Tennessee and Virginia.

Years since qualifying
13
Licensed in
KY, TN, VA
In the registry since
2014
Specialties on file
3
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

111 W Stone Dr Ste 110
Kingsport, TN 37660-6027
Phone: (423) 224-3701
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (10)

  • 1220 Volunteer Pkwy, Bristol, TN 37620-4628 — (423) 274-6610
  • 2686 W State St, Bristol, TN 37620-1817 — (423) 844-0026
  • 1497 W Elk Ave Ste 11, Elizabethton, TN 37643-2896 — (423) 542-8929
  • 115 Judge Gresham Rd Ste A, Gray, TN 37615-6213 — (423) 467-3000
  • 438 E Vann Rd Ste 301, Greeneville, TN 37743-7202 — (423) 636-9828
  • 161 Heart Dr Ste A, Johnson City, TN 37604-2607 — (423) 282-0751
  • 4600 Fort Henry Dr, Kingsport, TN 37663-2617 — (423) 224-3950
  • 231 S Fairmont Ave, Morristown, TN 37813-2036 — (423) 839-1600
  • 405 Scenic Dr Ste A, Rogersville, TN 37857-2441 — (423) 921-3490
  • 24530 Falcon Place Blvd Ste 100, Abingdon, VA 24211-7665 — (276) 619-0075

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 2543 (TN)
Physician Assistant Taxonomy 363A00000X · Licence 0110009681 (VA)
Physician Assistant Taxonomy 363A00000X · Licence 1903 (KY)

Record details

NPI number1487067534
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedJune 6, 2014
Last updated in NPPESJune 9, 2025
Certification dateJune 9, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Group practice Wellmont Medical Associates Inc — 435 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations7 on file with Medicare

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