NPIMap

Individual provider Active NPI

Justin Claude Moore, NURSE PRACTITIONER

  • Acute Care Nurse Practitioner
  • Greenville, SC
National Provider Identifier
1164180535
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
25609 Issued in SC
Practice address
701 Grove Rd FL 5
Greenville, SC 29605-4210
Phone
(864) 455-4411
Fax
(864) 455-4480
NPI assigned
Dec 2, 2021
Last updated
Dec 2, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 25609 SC Primary

Addresses

Primary practice location

701 Grove Rd FL 5
Greenville, SC 29605-4210

Mailing address

3 Saint Francis Dr Ste 360
Greenville, SC 29601-3972
Phone (864) 233-4349

Other practice location 1

3 Saint Francis Dr Ste 360
Greenville, SC 29601-3972
Phone (864) 233-4349

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220324002759 SC Practitioner - Nurse Practitioner 9032504295 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

701 Grove Rd
Suite 5
Greenville, SC 29605-4210
Phone (864) 455-4411

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.33 of 100Reported as group
Quality
75.48
Promoting interoperability
100
Improvement activities
40
Cost
72.29

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25609SCMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Dec 8, 2024 Accepting new patients
Prisma Health University Medical Group CurrentSince Dec 8, 2024 Accepting new patients
Prisma Health University Medical Group Single Specialty Current Accepting new patients
Bon Secours Medical Group Greenville Specialty Care LLC CurrentSince May 21, 2022 Accepting new patients
Bon Secours Medical Group Greenville Specialty Care LLC Single Specialty CurrentSince May 21, 2022 Accepting new patients
St Francis Physician Services Inc Single Specialty Past Accepting new patients
Greenville Health System PastSince Dec 8, 2024 Accepting new patients

Locations

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

2A Cleveland Ct
Greenville, SC 29607
Phone (864) 271-7761

3 Saint Francis Dr
Ste 360
Greenville, SC 29601
Phone (864) 233-4349

317 Saint Francis Dr
Ste 220
Greenville, SC 29601
Phone (864) 255-1901

701 Grove Rd
#5
Greenville, SC 29605
Phone (864) 455-4411

701 Grove Rd
Fl 5
Greenville, SC 29605
Phone (864) 455-4411

Interoperability endpoints

  • Direct secure messaging: jmoore825591@direct.ghs.myhfn.org

Organizations & group practices 7

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.

Hospital & facility affiliations 43

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

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1638403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1164180535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 SAINT FRANCIS DR STE 360",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296013972",
            "telephone_number": "864-233-4349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 GROVE RD FL 5",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054210",
            "telephone_number": "864-455-4411",
            "fax_number": "864-455-4480"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3 Saint Francis Dr Ste 360",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296013972",
            "country_code": "US",
            "telephone_number": "864-233-4349",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JUSTIN",
        "middle_name": "CLAUDE",
        "name_prefix": "Mr.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-12-02",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "SC",
            "license": "25609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.