Jennifer Renae Moore

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

1186147 Issued in TX

Practice address

120 Avalon St
Borger, TX 79007-8303

Phone

(806) 886-0177

NPI assigned

Apr 14, 2025

Last updated

Aug 5, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Castro County Hospital District

  dba Plains Memorial Hospital

  • Critical Access Hospital
  • Dimmitt, TX
  • NPI 1033118716
  Medicare reassignment NPD
• FMC Medical Foundation, Inc.

  • Family Medicine Physician
  • Amarillo, TX
  • NPI 1104255272
  NPD

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

{
    "created_epoch": "1744588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754352000000",
    "number": "1083409502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 AVALON ST",
            "city": "BORGER",
            "state": "TX",
            "postal_code": "790078303",
            "telephone_number": "806-886-0177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 AVALON ST",
            "city": "BORGER",
            "state": "TX",
            "postal_code": "790078303",
            "telephone_number": "806-886-0177"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 S Coulter St Ste 3",
            "address_purpose": "LOCATION",
            "city": "Amarillo",
            "state": "TX",
            "postal_code": "791061787",
            "country_code": "US",
            "telephone_number": "806-350-7601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JENNIFER",
        "middle_name": "RENAE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-04-14",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP1186147",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1186147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maxwell Chiropractic Services, P.a. (Revelations Chiropractic)
• Jamey Ray Maxwell, D.C.
• Vicente F Maza, MD
• Holly Ann McKee
• Mona Agarwal Dentistry PLLC (Borger Smiles)
• William Ray Myers II, P.T.
• Tami Lynn Newman, LVN
• Monica Sue Nozoor, NP
• NWTX Physician Network, PLLC
• NWTX Physician Network, PLLC

• Psychiatric/Mental Health Nurse Practitioner in Borger, TX
• Providers in Borger, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.