Individual provider Active NPI

Larika Danyelle Nicole Moore, CNP

  • Nurse Practitioner
  • Portsmouth, OH
National Provider Identifier
1093213613
Registry record updated Jun 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN.CNP.022226 Issued in OH
Practice address
1248 Kinneys LN
Portsmouth, OH 45662-2994
Phone
(740) 356-7290
Fax
(740) 356-7938
NPI assigned
Jan 29, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.022226 OH
Nurse Practitioner 363L00000X APRN.CNP.022226 OH Primary

Addresses

Primary practice location

1248 Kinneys LN
Portsmouth, OH 45662-2994

Mailing address

1735 27TH St Ste B06
Portsmouth, OH 45662-2681
Phone (740) 356-8681

Other practice location 1

1000 Veterans Dr
Jackson, OH 45640-9586
Phone (740) 395-8050

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address adena.fam.med.jackson@adena.medicity.net
Direct Messaging Address larika.moore@somc.medicity.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20180214001442 OH Practitioner - Nurse Practitioner 5395005250 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Somc Medical Care Foundation, Inc.Group PAC ID 9436061645, 388 clinicians

Practice addresses (Care Compare)

1248 Kinneys LN
Portsmouth, OH 45662-2927
Phone (740) 356-7290

Hospital & facility affiliations

  • Southern Ohio Medical Center Hospital, Portsmouth, OH, CCN 360008

Merit-based Incentive Payment System (MIPS)

Final score
82.59 of 100Reported as group
Quality
59.57
Promoting interoperability
100
Improvement activities
40
Cost
71.16

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN.CNP.022226OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Adena Medical Group LLC CurrentSince Feb 12, 2018 Accepting new patients
Somc Medical Care Foundation, Inc. CurrentSince Apr 30, 2022 Accepting new patients
Somc Medical Care Foundation, Inc. Nurse Practitioner CurrentSince Apr 30, 2022 Accepting new patients

Locations

4437 State Route 159
Ste 125
Chillicothe, OH 45601
Phone (740) 779-4570

1000 Veterans Dr
Jackson, OH 45640
Phone (740) 395-8050

1805 27th St
Portsmouth, OH 45662
Phone (740) 356-5000

1735 27th St
Ste B06
Portsmouth, OH 45662
Phone (740) 356-7942

1248 Kinneys Ln
Portsmouth, OH 45662
Phone (740) 353-2131

12340 State Route 104
Waverly, OH 45690
Phone (740) 941-5180

Organizations & group practices 3

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 1

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": "1517184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654128000000",
    "number": "1093213613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1735 27TH ST STE B06",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456622681",
            "telephone_number": "740-356-8681",
            "fax_number": "740-353-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1248 KINNEYS LN",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456622994",
            "telephone_number": "740-356-7290",
            "fax_number": "740-356-7938"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Veterans Dr",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "OH",
            "postal_code": "456409586",
            "country_code": "US",
            "telephone_number": "740-395-8050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "LARIKA",
        "middle_name": "DANYELLE NICOLE",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-29",
        "last_updated": "2022-06-02",
        "certification_date": "2022-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.022226",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "APRN.CNP.022226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adena.fam.med.jackson@adena.medicity.net",
            "affiliation": "N",
            "address_1": "1000 Veterans Dr",
            "city": "Jackson",
            "state": "OH",
            "country_code": "US",
            "postal_code": "456409586",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "larika.moore@somc.medicity.net",
            "affiliation": "N",
            "address_1": "1248 Kinneys Ln",
            "city": "Portsmouth",
            "state": "OH",
            "country_code": "US",
            "postal_code": "456622994",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portsmouth, OH

Sources for this page

Verify at the official NPI Registry.