Jennifer Nicole Moultrie

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

11019436 Issued in FL

Practice address

4929 Mobile Hwy
Pensacola, FL 32506-3229

Phone

(850) 960-7971

Fax

(850) 961-0011

NPI assigned

Aug 12, 2022

Last updated

Jul 9, 2025By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Georgetown University School of Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Medi Home Health Agency Home health agency, Pensacola, FL, CCN 108240
• Vitas Healthcare Corporation of Florida Hospice, Melbourne, FL, CCN 101545

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Grace Care Medical LLC

  • Physical Therapist
  • Pensacola, FL
  • NPI 1477378164

  Adult Health

  Medicare reassignment NPD Authorized official
• Gastroenterology Associates of Pensacola PA

  • Gastroenterology Physician
  • Pensacola, FL
  • NPI 1235223785
  NPD (past)

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

• Traditional Home Care, Inc.

  dba Medi Home Health Agency

  • Home Health Agency
  • Pensacola, FL
  • NPI 1568415099
  Care Compare affiliation
• Vitas Healthcare Corporation of Florida

  • Community Based Hospice Care Agency
  • Boynton Beach, FL
  • NPI 1467507657
  Care Compare affiliation
• Vitas Healthcare Corporation of Florida

  • Community Based Hospice Care Agency
  • Miami Lakes, FL
  • NPI 1528113792
  Care Compare affiliation
• Vitas Healthcare Corporation of Florida

  • Community Based Hospice Care Agency
  • Melbourne, FL
  • NPI 1669548053
  Care Compare affiliation
• Vitas Healthcare Corporation of Florida

  • Community Based Hospice Care Agency
  • Tallahassee, FL
  • NPI 1972555464
  Care Compare affiliation

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

{
    "created_epoch": "1660262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752019200000",
    "number": "1346978608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4929 MOBILE HWY",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325063229",
            "telephone_number": "850-712-5877",
            "fax_number": "850-961-0011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4929 MOBILE HWY",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325063229",
            "telephone_number": "850-960-7971",
            "fax_number": "850-961-0011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOULTRIE",
        "first_name": "JENNIFER",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-12",
        "last_updated": "2025-07-09",
        "certification_date": "2025-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "APRN11019436",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "11019436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marie Brady Mott, MS, RDN, CSSD, LDN
• Ava Moulder
• Moulds Chiropractic LLC
• Moulds Chiropractic LLC
• Ryan Moulds, D.C.
• Asaad Mouselli
• Karl Mueller, MD/PHD
• Richard J Muench, MD
• Matthew Muir
• Aaron Michael Mulhall, MD

• Adult Health Nurse Practitioner in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Adult Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.