Nicole Yvette Moore, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN132595 Issued in GA

Practice address

1400 Holcomb Bridge Rd
Roswell, GA 30076

Phone

(770) 587-8000

NPI assigned

Aug 7, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• East Clinic LLC

  • Family Medicine Physician
  • Dallas, GA
  • NPI 1831563261
  NPD (past)

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

{
    "created_epoch": "1218067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564704000000",
    "number": "1154587376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2145 LIBERTY BELL PL",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300434929",
            "telephone_number": "404-645-2883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 HOLCOMB BRIDGE RD",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "30076",
            "telephone_number": "770-587-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "539 Hardee St",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "GA",
            "postal_code": "301324711",
            "country_code": "US",
            "telephone_number": "770-505-0531",
            "fax_number": "770-505-0534",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "NICOLE",
        "middle_name": "YVETTE",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-07",
        "last_updated": "2019-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN132595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda S Moore, LMSW
• Caroline Moore, OTR/L
• Demetrius Moore, ND
• Elizabeth Moore, MSOT, OTR/L
• Kim Moore, MS, LPC
• Kiara Mora-Ramirez
• Nathan Mordel, MD
• Belton Anthony Morgan Jr., MT-BC
• Ryan Morissaint
• Eboni R. Mormant, LPC

• Family Nurse Practitioner in Roswell, GA
• Providers in Roswell, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.