Individual provider Active NPI

Joyce Marie Moore, APRN, FNP-C

  • Family Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1386058717
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9415242 Issued in FL
Practice address
17511 Bruce B Downs Blvd
Tampa, FL 33647-3211
Phone
(813) 915-5459
Fax
(813) 971-5468
NPI assigned
Jun 13, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 ARNP9415242 FL Primary

Addresses

Primary practice location

17511 Bruce B Downs Blvd
Tampa, FL 33647-3211

Mailing address

17511 Bruce B Downs Blvd
Tampa, FL 33647-3211
Phone (813) 915-5459

Other identifiers 1

IdentifierTypeStateIssuer
003150449AMedicaidGA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160817001609 FL Practitioner - Nurse Practitioner 7012138118 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dedicated Senior Medical Center of Florida, LLC CurrentSince Sep 18, 2017 Accepting new patients
Dedicated Senior Medical Center of Florida, LLC CurrentSince Sep 18, 2017 Accepting new patients
Florida Hospital Physician Group Inc Family CurrentSince Sep 5, 2017 Accepting new patients
Hospital Authority of Jefferson County and the City of Louisville Past Accepting new patients

Locations

206 N Florida Ave
Lakeland, FL 33801
Phone (863) 209-7003

4715 S Florida Ave
Lakeland, FL 33813
Phone (863) 209-7003

1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760

17511 Bruce B Downs Blvd
Tampa, FL 33647
Phone (813) 903-8404

13901 Bruce B Downs Blvd
Tampa, FL 33613
Phone (813) 615-7260

2700 Healing Way
Ste 310
Wesley Chapel, FL 33543
Phone (813) 779-1209

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1402617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1386058717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17511 BRUCE B DOWNS BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336473211",
            "telephone_number": "813-915-5459",
            "fax_number": "813-971-5468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17511 BRUCE B DOWNS BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336473211",
            "telephone_number": "813-915-5459",
            "fax_number": "813-971-5468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JOYCE",
        "middle_name": "MARIE",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-13",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9415242",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003150449A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.