Individual provider Active NPI

Sierra Moore, PA

  • Physician Assistant
  • Tucker, GA
National Provider Identifier
1215412754
Registry record updated Oct 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
GA9015 Issued in GA
Practice address
1462 Montreal Rd Ste 212
Tucker, GA 30084-6931
Phone
(770) 800-4357
Fax
(470) 709-5810
NPI assigned
Oct 1, 2018
Last updated
Oct 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X GA9015 GA Primary

Addresses

Primary practice location

1462 Montreal Rd Ste 212
Tucker, GA 30084-6931

Mailing address

1462 Montreal Rd Ste 212
Tucker, GA 30084-6931
Phone (770) 800-4357

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20190207000332 GA Practitioner - Physician Assistant 5597003160 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
009015GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Non-Surgical Orthopaedics PC CurrentSince Apr 1, 2023 Accepting new patients

Locations

418 Bradley St
Carrollton, GA 30117
Phone (770) 214-9146

1301 Sigman Rd NE
Ste 100
Conyers, GA 30012
Phone (770) 285-6012

335 Roselane St NW
Marietta, GA 30060
Phone (770) 420-4645

Interoperability endpoints

  • Direct secure messaging: sierra.moore.p1@direct.precisionspinecare.nextgenshare.com
  • Direct secure messaging: sierra.moore.p3@direct.precisionspinecare.nextgenshare.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1538352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1793232000000",
    "number": "1215412754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1462 MONTREAL RD STE 212",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300846931",
            "telephone_number": "770-800-4357",
            "fax_number": "470-709-5810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1462 MONTREAL RD STE 212",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300846931",
            "telephone_number": "770-800-4357",
            "fax_number": "470-709-5810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "SIERRA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-01",
        "last_updated": "2026-10-29",
        "certification_date": "2026-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "GA9015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucker, GA

Sources for this page

Verify at the official NPI Registry.