Crystal Wade Moore, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

222790 Issued in GA

Practice address

448 W Belmont Dr
Calhoun, GA 30701-3016

Phone

(762) 204-6444

NPI assigned

Apr 7, 2020

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

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

Medicare enrollment (NPD)

Enrolled

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.

• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  GA

  Medicare reassignment NPD
• Family Medical Therapies PLLC

  • Family Medicine Physician
  • Ft Oglethorpe, GA
  • NPI 1225585037
  NPD
• MC Medical LLC

  • General Practice Physician
  • Dallas, GA
  • NPI 1356907695
  NPD

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

{
    "created_epoch": "1586217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710460800000",
    "number": "1386273753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "448 W BELMONT DR",
            "city": "CALHOUN",
            "state": "GA",
            "postal_code": "307013016",
            "telephone_number": "762-204-6444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "448 W BELMONT DR",
            "city": "CALHOUN",
            "state": "GA",
            "postal_code": "307013016",
            "telephone_number": "762-204-6444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "CRYSTAL",
        "middle_name": "WADE",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-07",
        "last_updated": "2024-03-15",
        "certification_date": "2024-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "222790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie L Mitchell, PT
• Modern Medical, LLC
• Mayur D Mody, M.D.
• Monyei Holdings Inc
• Nikitia Yvette Moore-Floyd
• Katie Moraitakis, LCSW
• Lacy Autumn Moran, NP
• Sandra Gail Morgan, CCC-SLP
• Tyler Morris, DC
• Stephani Morss, APC

• Family Nurse Practitioner in Calhoun, GA
• Providers in Calhoun, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.