Deanna Moore, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F03190439 Issued in NC

Practice address

PO Box 211699
Eagan, MN 55121-3699

Phone

(866) 849-0692

Fax

(888) 973-8821

NPI assigned

Jul 25, 2019

Last updated

Sep 8, 2026By 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 12

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mainstreet and Kidsstreet of North Carolina PLLCGroup PAC ID 6901290238, 76 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Mainstreet and Kidsstreet of North Carolina PLLC

  • Urgent Care Clinic/Center
  • Locust, NC
  • NPI 1144803040
  Medicare reassignment Care Compare group NPD
• Mainstreet and Kidsstreet of North Carolina PLLC

  • Urgent Care Clinic/Center
  • Burlington, NC
  • NPI 1043170558
  NPD
• Mainstreet and Kidsstreet of North Carolina PLLC

  dba MainStreet Family Care

  • Rural Health Clinic/Center
  • Tarboro, NC
  • NPI 1740076504
  NPD
• Mainstreet and Kidsstreet of North Carolina PLLC

  dba MainStreet Family Care

  • Urgent Care Clinic/Center
  • Tarboro, NC
  • NPI 1801503222
  NPD
• Bertie County Rural Health Association

  dba Windsor Community Health Center Pharmacy

  • Clinic Pharmacy
  • Windsor, NC
  • NPI 1801427711
  NPD (past)

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

{
    "created_epoch": "1564012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788825600000",
    "number": "1447804752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 211699",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551213699",
            "telephone_number": "866-849-0692",
            "fax_number": "888-973-8821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 211699",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551213699",
            "telephone_number": "866-849-0692",
            "fax_number": "888-973-8821"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 Western Blvd",
            "address_purpose": "LOCATION",
            "city": "Tarboro",
            "state": "NC",
            "postal_code": "278864858",
            "country_code": "US",
            "telephone_number": "252-774-4250",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "307 South Main St",
            "address_purpose": "LOCATION",
            "city": "Lewiston",
            "state": "NC",
            "postal_code": "27849",
            "country_code": "US",
            "telephone_number": "252-348-2545",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "104 Rhodes Ave",
            "address_purpose": "LOCATION",
            "city": "Windsor",
            "state": "NC",
            "postal_code": "279839656",
            "country_code": "US",
            "telephone_number": "252-734-3042",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "DEANNA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-25",
        "last_updated": "2026-09-08",
        "certification_date": "2026-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024193943",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "3-003110",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209035995",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1245509",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "HI",
            "license": "5940",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP036433",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11049689",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "F03190439",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2026036722",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "908619",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "32680",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "42334",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abolfazl Monzavi, OD
• Emily Catherwood Moody, MD, MHS
• Bai Tina Moore
• Chester Lee Moore Jr., CPHT
• Christine Ann Moore, RN, CDCES
• Kristie Moore
• Nina Moore, OT
• Patricia Moore
• Trolane Moore
• Diana C Moran, APRN, FNP-C

• Family Nurse Practitioner in Eagan, MN
• Providers in Eagan, MN by specialty
• Family Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2026; 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.