Individual provider Active NPI

Madison Nunnery Moore, NP

  • Neonatal Nurse Practitioner
  • Covington, LA
National Provider Identifier
1033967963
Registry record updated Apr 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
212861 Issued in LA
Practice address
1202 S Tyler St
Covington, LA 70433-2330
Phone
(985) 898-4000
NPI assigned
May 7, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X 212861 LA Primary

Addresses

Primary practice location

1202 S Tyler St
Covington, LA 70433-2330

Mailing address

18318 Bellingrath Lakes Ave
Greenwell Springs, LA 70739-4760
Phone (225) 933-1416

Other practice location 1

8300 Constantin Blvd
Baton Rouge, LA 70809-3489
Phone (225) 374-1470

Other names 1

  • Madison Marie Nunnery Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20260624001862 LA Practitioner - Nurse Practitioner 3870066533 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816-6038

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
212861LAMDNeonatal Nurse Practitioner

Organizations & group practices 1

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": "1715040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777334400000",
    "number": "1033967963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18318 BELLINGRATH LAKES AVE",
            "city": "GREENWELL SPRINGS",
            "state": "LA",
            "postal_code": "707394760",
            "telephone_number": "225-933-1416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 S TYLER ST",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704332330",
            "telephone_number": "985-898-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8300 Constantin Blvd",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "708093489",
            "country_code": "US",
            "telephone_number": "225-374-1470",
            "fax_number": "225-374-1646",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MADISON",
        "middle_name": "NUNNERY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-07",
        "last_updated": "2026-04-28",
        "certification_date": "2026-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "LA",
            "license": "212861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MADISON",
            "last_name": "NUNNERY",
            "middle_name": "MARIE",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Covington, LA

Sources for this page

Verify at the official NPI Registry.