Individual provider Active NPI

Jasmyne S Moore, APRN, MSN

  • Family Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1184514267
Registry record updated Jul 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11040732 Issued in FL
Practice address
12313 Rouen Cove Dr
Jacksonville, FL 32226-4986
Phone
(732) 213-7169
NPI assigned
Jul 8, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11040732 FL Primary

Addresses

Primary practice location

12313 Rouen Cove Dr
Jacksonville, FL 32226-4986

Mailing address

12313 Rouen Cove Dr
Jacksonville, FL 32226-4986
Phone (732) 213-7169

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20251107001703 NJ Practitioner - Nurse Practitioner 0345730313 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ennoble HC NJ PCGroup PAC ID 0345638185, 129 clinicians

Practice addresses (Care Compare)

2 University PLZ
Suite 204
Hackensack, NJ 07601-6211
Phone (973) 241-1356

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11040732FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ennoble HC NJ PC CurrentSince Nov 17, 2025 Accepting new patients
Ennoble HC NJ III PC CurrentSince Sep 12, 2025 Accepting new patients
Ennoble HC NJ II PC CurrentSince Sep 12, 2025 Accepting new patients

Locations

2 University Plz
Ste 204
Hackensack, NJ 07601
Phone (201) 564-0142

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 4

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": "1751932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751932800000",
    "number": "1184514267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12313 ROUEN COVE DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322264986",
            "telephone_number": "732-213-7169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12313 ROUEN COVE DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322264986",
            "telephone_number": "732-213-7169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JASMYNE",
        "middle_name": "S",
        "name_prefix": "Ms.",
        "credential": "APRN, MSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-08",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11040732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.