Megan Jo Moore

Primary specialty

Critical Care Medicine Nurse PractitionerTaxonomy code 363LC0200X

License

0042543 Issued in OH

Practice address

1320 Mercy Dr NW
Canton, OH 44708-2614

Phone

(330) 489-1000

NPI assigned

Mar 3, 2026

Last updated

Jun 25, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Megan Jo Nicodemus Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Specialty

Nurse Practitioner

Education

Other, 2026

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1772496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782345600000",
    "number": "1326993528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "741 E TUSCARAWAS AVE",
            "city": "BARBERTON",
            "state": "OH",
            "postal_code": "442033719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 MERCY DR NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447082614",
            "telephone_number": "330-489-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MEGAN",
        "middle_name": "JO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-03-03",
        "last_updated": "2026-06-25",
        "certification_date": "2026-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "OH",
            "license": "0042543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEGAN",
            "last_name": "NICODEMUS",
            "middle_name": "JO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jacqueline K Moore, QMHS
• Kelly M Moore, LSW
• Kimberlee E Moore
• Lindsea Noel Moore, MS, RD, LD
• Maria Frances Moore
• Rashaune Moore, LPN
• Theodora Elizabeth Moore
• Tierra Moore
• Zipporah Moore
• Kimberly D Moraghan, LPCC-S

• Critical Care Medicine Nurse Practitioner in Canton, OH
• Providers in Canton, OH by specialty
• Critical Care Medicine Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2026; 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.