Donna A Moore, APRN-C, PMHNP-BC, MS

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RN241756 Issued in GA

Practice address

915 Interstate Ridge Dr
Gainesville, GA 30501-7076

Phone

(516) 493-2203

NPI assigned

Dec 26, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Multi-Specialty

  Medicare reassignment NPD
• Mental Health Specialty Group PA

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634

  FL, Multi-Specialty

  Medicare reassignment NPD
• Georgia Mountains Community Services

  • Mental Health Counselor
  • Dawsonville, GA
  • NPI 1619360849

  Multi-Specialty

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1198627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741737600000",
    "number": "1003090150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "599 MADISON PARK DR",
            "city": "GRAYSON",
            "state": "GA",
            "postal_code": "300177940",
            "telephone_number": "516-493-2203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 INTERSTATE RIDGE DR",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305017076",
            "telephone_number": "516-493-2203"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 Franklin Ave",
            "address_purpose": "LOCATION",
            "city": "Valley Stream",
            "state": "NY",
            "postal_code": "115802145",
            "country_code": "US",
            "telephone_number": "516-493-2203",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "599 Madison Park Dr",
            "address_purpose": "LOCATION",
            "city": "Grayson",
            "state": "GA",
            "postal_code": "300177940",
            "country_code": "US",
            "telephone_number": "516-493-2203",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "801 W Bay Dr Ste 424",
            "address_purpose": "LOCATION",
            "city": "Largo",
            "state": "FL",
            "postal_code": "337703234",
            "country_code": "US",
            "telephone_number": "516-493-2203",
            "fax_number": "516-493-2203",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "DONNA",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "APRN-C, PMHNP-BC, MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-26",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "5796691",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "RN241756",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "95029693",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "11034073",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN241756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Bruce Moomey Jr., MD
• Brian Thomas Moore, PT, DPT
• Cynthia Ann Moore, MD
• Denika L Moore, LD CPS FPM
• Derek Ronald Moore, MD
• Frederick Stephen Moore, MD
• Mark Phillip Moore, DMD
• Sandy Townsend Moore, LPN
• Ana N Moreira, LCSW, NBCCH, MAC
• Jaime L Morel Ruiz, M.D.

• Psychiatric/Mental Health Nurse Practitioner in Gainesville, GA
• Providers in Gainesville, GA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.