Individual provider Active NPI

Jaymie Moore, APRN

  • Nurse Practitioner
  • Enid, OK
National Provider Identifier
1013889633
Registry record updated Sep 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
225170 Issued in OK
Practice address
220 S Van Buren St
Enid, OK 73703-5812
Phone
(580) 234-9355
NPI assigned
Sep 22, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 225170 OK Primary

Addresses

Primary practice location

220 S Van Buren St
Enid, OK 73703-5812

Mailing address

2902 W Chestnut Ave
Enid, OK 73703-3908

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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

Enrollment IDStateProvider typePAC IDDetails
I20251028002936 OK Practitioner - Nurse Practitioner 1850880113 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Williams Medical Group Practice, LLCGroup PAC ID 3375832157, 212 clinicians

Practice addresses (Care Compare)

220 S Van Buren St
Xpress Wellness Urgent Care
Enid, OK 73703-5812
Phone (580) 234-9355

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
225170OKMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Williams Medical Group Practice, LLC CurrentSince Oct 16, 2025 Accepting new patients
Williams Medical Group Practice, LLC CurrentSince Oct 16, 2025 Accepting new patients

Locations

220 S Van Buren St
Enid, OK 73703
Phone (580) 234-9355

777 NW 63rd St
Fl 2
Oklahoma City, OK 73116

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1758499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758499200000",
    "number": "1013889633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2902 W CHESTNUT AVE",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737033908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 S VAN BUREN ST",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737035812",
            "telephone_number": "580-234-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JAYMIE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-22",
        "last_updated": "2025-09-22",
        "certification_date": "2025-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OK",
            "license": "225170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enid, OK

Sources for this page

Verify at the official NPI Registry.