Jerrica Chambers Moore, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9116884 Issued in FL

Practice address

10909 W Linebaugh Ave Ste 101
Tampa, FL 33626-1741

Phone

(813) 844-4800

Fax

(813) 844-1103

NPI assigned

May 4, 2017

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

Other identifiers 2

Electronic endpoints 2

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

Physician Assistant

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Tampa General Medical Group IncGroup PAC ID 7416253828, 353 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tampa General Hospital Hospital, Tampa, FL, CCN 100128

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jmoore282006@direct.tgh.org
• FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/

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.

• Tampa General Medical Group Inc

  dba TGMG Bayshore

  • Surgery Physician
  • Tampa, FL
  • NPI 1043557853
  Medicare reassignment Care Compare group
• Tampa General Hospital

  • General Acute Care Hospital
  • Tampa, FL
  • NPI 1124558929
  NPD
• Tampa General Medical Group Inc

  dba TGH Heart & Vascular Institute Sun City

  • Cardiovascular Disease Physician
  • Sun City Center, FL
  • NPI 1144910316
  NPD
• Tampa General Medical Group Inc

  dba TGMG Sunlake

  • Family Medicine Physician
  • Lutz, FL
  • NPI 1407698566
  NPD

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

• Florida Health Sciences Center Inc

  dba Tampa General Hospital

  • General Acute Care Hospital
  • Tampa, FL
  • NPI 1235196510
  Care Compare affiliation

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

{
    "created_epoch": "1493856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712707200000",
    "number": "1437685898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1289",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336011289",
            "telephone_number": "813-844-4800",
            "fax_number": "813-844-1103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10909 W LINEBAUGH AVE STE 101",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336261741",
            "telephone_number": "813-844-4800",
            "fax_number": "813-844-1103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JERRICA",
        "middle_name": "CHAMBERS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-04",
        "last_updated": "2024-04-10",
        "certification_date": "2023-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NH",
            "license": "1262",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9116884",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3109599",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "1262",
            "state": "NH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wolfeborofamilymed@gohnh.allscriptsdirect.net",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct messaging",
            "address_1": "240 S Main St # A",
            "city": "Wolfeboro",
            "state": "NH",
            "country_code": "US",
            "postal_code": "038944411",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmoore282006@direct.tgh.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "10909 W Linebaugh Ave Ste 101",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336261741",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Holly Ann Moore
• Janel Nicole Moore, APRN
• Jared Dylan Moore, FNP-BC
• Jason Michael Moore, D.M.D.
• Jay Winston Moore, PH.D., FACMG
• Joanne Marie Moore
• Jonette Rae Moore, ARNP
• Joyce Marie Moore, APRN, FNP-C
• Kelly Moore, APRN
• Kelsey Alexandra Moore

• Physician Assistant in Tampa, FL
• Providers in Tampa, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 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.
• 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.