Marissa Michelle Moore, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

APRN.CNP.0037466 Issued in OH

Practice address

5060 Bradenton Ave Ste a
Dublin, OH 43017-3511

Phone

(216) 407-1647

NPI assigned

Sep 18, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Quest Recovery Center, LLCGroup PAC ID 3476974718, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Quest Recovery Center, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Mount Vernon, OH
  • NPI 1104450063
  Medicare reassignment Care Compare group
• Ketamine Health & Wellness Clinics of Ohio LLC

  • Psychiatry Physician
  • Dublin, OH
  • NPI 1053005116
  Medicare reassignment NPD
• Central Ohio Podiatry Group Inc

  • Foot & Ankle Surgery Podiatrist
  • Westerville, OH
  • NPI 1710033535
  NPD
• Quest Recovery Center, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mount Vernon, OH
  • NPI 1174283436
  NPD
• Ridgeline Recovery LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Columbus, OH
  • NPI 1235823931
  NPD (past)

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

{
    "created_epoch": "1694995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745539200000",
    "number": "1215715784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5060 BRADENTON AVE STE A",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430173511",
            "telephone_number": "216-407-1647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5060 BRADENTON AVE STE A",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430173511",
            "telephone_number": "216-407-1647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MARISSA",
        "middle_name": "MICHELLE",
        "name_prefix": "Ms.",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-18",
        "last_updated": "2025-04-25",
        "certification_date": "2025-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "OH",
            "license": "473399",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.0037466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Ann Moore
• Jeramie Ronnell Moore
• Kristen Moore
• Kyle Moore
• Mandi Moore
• Melinda Moore, CDCA
• Micah Moore
• Michelle Moore, RN
• Natalie Moore, RBT
• Patricia Moore

• Psychiatric/Mental Health Nurse Practitioner in Dublin, OH
• Providers in Dublin, OH by specialty
• Psychiatric/Mental Health Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.