Individual provider Active NPI

Janna Mullis Moody, APRN

  • Family Nurse Practitioner
  • Waycross, GA
National Provider Identifier
1467085217
Registry record updated Feb 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN258973 Issued in GA
Practice address
1218 Alice St
Waycross, GA 31501-4525
Phone
(912) 590-0973
Fax
(912) 590-0180
NPI assigned
Feb 20, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2024

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 RN258973 GA Primary

Addresses

Primary practice location

1218 Alice St
Waycross, GA 31501-4525

Mailing address

5191 First Coast Tech Pkwy FL 3
Jacksonville, FL 32224-0609
Phone (904) 256-2754

Other identifiers 1

IdentifierTypeStateIssuer
003230782MedicaidGA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20200409003380 GA Practitioner - Nurse Practitioner 2567891666 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Consultants in Pain Medicine LLCGroup PAC ID 7911975248, 16 clinicians

Practice addresses (Care Compare)

1218 Alice St
Waycross, GA 31501-4525
Phone (912) 590-0973

Hospital & facility affiliations

  • Memorial Satilla Health Hospital, Waycross, GA, CCN 110003
  • Bacon County Hospital Hospital, Alma, GA, CCN 111327

Merit-based Incentive Payment System (MIPS)

Final score
81.8 of 100Reported as group
Quality
77.71
Promoting interoperability
95
Improvement activities
40
Cost
65.81

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN258973GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Consultants in Pain Medicine, LLC CurrentSince Mar 4, 2024 Accepting new patients
Consultants in Pain Medicine, LLC CurrentSince Mar 4, 2024 Accepting new patients

Locations

10475 Centurion Pkwy N
Ste 201
Jacksonville, FL 32256
Phone 90422333213118

5191 First Coast Tech Pkwy
Fl 3
Jacksonville, FL 32224
Phone (904) 222-3332

3408 Trout St
Brunswick, GA 31520
Phone (912) 267-9000

1218 Alice St
Waycross, GA 31501
Phone (912) 264-9029

Interoperability endpoints

  • Direct secure messaging: janna.moody@jspc.eclinicaldirectplus.com
  • Direct secure messaging: janna.moody@bacon.gadirect.net

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1582156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1467085217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5191 FIRST COAST TECH PKWY FL 3",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322240609",
            "telephone_number": "904-256-2754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1218 ALICE ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315014525",
            "telephone_number": "912-590-0973",
            "fax_number": "912-590-0180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOODY",
        "first_name": "JANNA",
        "middle_name": "MULLIS",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-20",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN258973",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003230782",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waycross, GA

Sources for this page

Verify at the official NPI Registry.