Individual provider Active NPI

Kumarie Moore

  • Psychiatric/Mental Health Nurse Practitioner
  • Warrenton, VA
National Provider Identifier
1124873666
Registry record updated Sep 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0024189872 Issued in VA
Practice address
7293 Iron Bit Dr
Warrenton, VA 20186-6127
Phone
(571) 643-4637
NPI assigned
Apr 18, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0024189872 VA Primary

Addresses

Primary practice location

7293 Iron Bit Dr
Warrenton, VA 20186-6127

Mailing address

7293 Iron Bit Dr
Warrenton, VA 20186-6127
Phone (571) 643-4637

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20260116000138 VA Practitioner - Nurse Practitioner 2769969187 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

123 S Lynnhaven Rd
Suite 102
Virginia Beach, VA 23452-7401

PO Box
Pittsburgh, PA 15264

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0024189872VAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Care Aco LLC CurrentSince Dec 1, 2025 Accepting new patients
Legacy Care LLC CurrentSince Dec 1, 2025 Accepting new patients

Locations

7600 Autumn Park Way
Mechanicsvlle, VA 23116
Phone (804) 730-0009

2901 S Lynnhaven Rd
Ste 450
Virginia Beach, VA 23452
Phone (757) 351-4585

780 Lynnhaven Pkwy
Ste 400
Virginia Beach, VA 23452
Phone (201) 581-3411

123 S Lynnhaven Rd
Ste 102
Virginia Beach, VA 23452

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": "1713398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757030400000",
    "number": "1124873666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7293 IRON BIT DR",
            "city": "WARRENTON",
            "state": "VA",
            "postal_code": "201866127",
            "telephone_number": "571-643-4637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7293 IRON BIT DR",
            "city": "WARRENTON",
            "state": "VA",
            "postal_code": "201866127",
            "telephone_number": "571-643-4637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "KUMARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-18",
        "last_updated": "2025-09-05",
        "certification_date": "2025-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024189872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warrenton, VA

Sources for this page

Verify at the official NPI Registry.