Mark Benton Moore
ARNP | Nurse Practitioner - Pediatrics
1000 Blythe Blvd, Charlotte
North Carolina, 28203-5812
704-355-4772
Mark Benton Moore is a Charlotte, North Carolina based nurse practitioner who is specialized as Pediatrics nurse. Active license number of Mark Benton Moore is 9700154 for Pediatrics in North Carolina. His current practice location is 1000 Blythe Blvd, Charlotte. Patients can reach him at 704-355-4772 or can fax him at 704-355-6227. Mark Benton Moore is ARNP with specialization in Pediatrics and his NPI number (Unique professional ID assigned by NPPES) is 1205948981.
Mark Benton Moore specializes in caring for newborns, infants, toddlers, adolescents and young adults. He perform pediatric health care maintenance, including well child exams, developmental screenings and in-depth physical assessments, such as vision, hearing and dental. Pediatrics Nurse Practitioner (PNP) focus on well-child care and the prevention or management of common pediatric acute illnesses and chronic conditions.
Complete Profile:
Mark Benton Moore speciality, credentials, practice address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointment.
| Name: | Mark Benton Moore |
| Specialization: | Pediatrics Nurse Practitioner (PNP) |
| Gender: | Male |
| Credentials: | ARNP |
| Practice Address: | 1000 Blythe Blvd, Charlotte,
North Carolina, 28203-5812 |
| Phone: | 704-355-4772 |
| Fax: | 704-355-6227 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
| NPI Number: | 1205948981 |
| NPI Enumeration Date: | 31 Aug, 2006 |
| NPI Last Update On: | 06 Dec, 2021 |
Medical Licenses:
NPs can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Mark Benton Moore are as mentioned below.
| License Number | Specialization | State | Status | |
| 9700154 | Pediatrics | North Carolina | Primary | |
| 18527 | Nurse Practitioner | Tennessee | Secondary | |
| ARNP 9219935 | Pediatrics | Florida | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers associated with Mark Benton Moore such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| NP1153 | Medicaid | South Carolina | |
| 7005122 | Medicaid | North Carolina | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Mark Benton Moore
Po Box 601372,
Charlotte, North Carolina |
| Zip: | 28260-1372 |
| Phone Number: | 704-355-4772 |
| Fax Number: | 704-355-6227 |
Patients can reach Mark Benton Moore at
1000 Blythe Blvd, Charlotte, North Carolina or can
call to book an appointment on 704-355-4772.
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Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.