Jessica Havard Moran, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R871245 Issued in MS

Practice address

5501 Marvin Shields Blvd BLDG 472
Gulfport, MS 39501-9007

Phone

(228) 871-4033

NPI assigned

Feb 9, 2009

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 identifiers 1

Other names 1

• Mrs. Jessica Leigh Havard Former name

Medicare fee-for-service enrollment

Enrolled in MS

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

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.

• Coastal Family Health Center, Inc

  dba Coastal Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Biloxi, MS
  • NPI 1629066782
  Medicare reassignment NPD
• Memorial Hospital at Gulfport

  • Urology Physician
  • Gulfport, MS
  • NPI 1093142598

  Nurse Practitioner

  Medicare reassignment NPD
• Memorial Hospital at Gulfport

  dba Memorial Surgery Center Cedar Lake

  • General Acute Care Hospital
  • Biloxi, MS
  • NPI 1215546635
  NPD
• Memorial Hospital at Gulfport

  dba Memorial Emergency Physicians

  • Emergency Medicine Physician
  • Gulfport, MS
  • NPI 1962780379
  NPD

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

{
    "created_epoch": "1234137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656979200000",
    "number": "1386883791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5501 MARVIN SHIELDS BLVD BLDG 472",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395019007",
            "telephone_number": "228-871-4033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 MARVIN SHIELDS BLVD BLDG 472",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395019007",
            "telephone_number": "228-871-4033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAN",
        "first_name": "JESSICA",
        "middle_name": "HAVARD",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-09",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R871245",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08821006",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "HAVARD",
            "middle_name": "LEIGH",
            "prefix": "MRS.",
            "credential": "FNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tracy Moore, RBT
• Janet Eugenie Mora
• Alexa Morales, LCSW
• Brooke Moran
• Elizabeth Moran, CPSS
• Lacy Anne-Marie Moran
• Olivia Moran, PA-C
• Aaliyah Morgan
• Cassandra F Morgan, LPC
• Madeleine Morgan

• Family Nurse Practitioner in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2022; 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.