Individual provider Active NPI

Jennifer Evans Moore, NP

  • Family Nurse Practitioner
  • Vass, NC
National Provider Identifier
1053015255
Registry record updated Mar 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5017869 Issued in NC
Practice address
3349 US 1 Hwy
Vass, NC 28394
Phone
(910) 245-7678
Fax
(910) 245-3251
NPI assigned
Mar 30, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5017869 NC Primary

Addresses

Primary practice location

3349 US 1 Hwy
Vass, NC 28394

Mailing address

3349 US 1 Hwy
Vass, NC 28394
Phone (910) 245-7678

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20230505001905 NC Practitioner - Nurse Practitioner 9638534118 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
FHPG LLCGroup PAC ID 9537481569, 195 clinicians

Practice addresses (Care Compare)

3349 US 1 Hwy
Vass, NC 28394
Phone (910) 245-7678

Hospital & facility affiliations

  • Firsthealth Moore Regional Hospital Hospital, Pinehurst, NC, CCN 340115

Merit-based Incentive Payment System (MIPS)

Final score
85.84 of 100Reported as group
Quality
79.14
Promoting interoperability
92
Improvement activities
40
Cost
80.32

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5017869NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
FHPG, LLC CurrentSince Apr 15, 2023 Accepting new patients
FHPG, LLC CurrentSince Apr 15, 2023 Accepting new patients
FHPG, LLC Current Accepting new patients
FHPG, LLC Past Accepting new patients

Locations

46 Memorial Dr
Pinehurst, NC 28374
Phone (910) 295-6782

3349 US 1 Hwy
Vass, NC 28394
Phone (910) 245-7678

Interoperability endpoints

  • Direct secure messaging: jmoore11112@firsthealth.direct-ci.net

Organizations & group practices 5

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1680134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680134400000",
    "number": "1053015255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3349 US 1 HWY",
            "city": "VASS",
            "state": "NC",
            "postal_code": "28394",
            "telephone_number": "910-245-7678",
            "fax_number": "910-245-3251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3349 US 1 HWY",
            "city": "VASS",
            "state": "NC",
            "postal_code": "28394",
            "telephone_number": "910-245-7678",
            "fax_number": "910-245-3251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JENNIFER",
        "middle_name": "EVANS",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-30",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5017869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vass, NC

Sources for this page

Verify at the official NPI Registry.