Mary Christine Moore, CFNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R883220 Issued in MS

Practice address

1626 Highway 30 E
Oxford, MS 38655

Phone

(662) 371-1326

Fax

(662) 371-1325

NPI assigned

Oct 22, 2012

Last updated

Sep 20, 2023By 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 2

Addresses

Other identifiers 4

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

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermatology Associates of Oxford LLCGroup PAC ID 7810237153, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/3694/brand/1/csg/1/fhir/r4

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.

• Dermatology Associates of Oxford, LLC

  dba Dermatology Associates of Oxford

  • Dermatology Physician
  • Oxford, MS
  • NPI 1588151310
  Medicare reassignment Care Compare group NPD
• Lyndsay R Shipp MD PLLC

  • Clinic/Center
  • Oxford, MS
  • NPI 1669879532
  NPD (past)
• Tratan LLC

  dba Treatment Rooms of America TAN

  • Clinic/Center
  • Memphis, TN
  • NPI 1134427396
  NPD (past)

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

{
    "created_epoch": "1350864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1477806909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1158",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386551158",
            "telephone_number": "662-371-1326",
            "fax_number": "662-371-1325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1626 HIGHWAY 30 E",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "38655",
            "telephone_number": "662-371-1326",
            "fax_number": "662-371-1325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MARY",
        "middle_name": "CHRISTINE",
        "credential": "CFNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-22",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN0000017955",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R883220",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVANCED PRACTICE NURSE",
            "identifier": "APN0000017955",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN",
            "identifier": "RN0000196837",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSING LICENSE NUMBER",
            "identifier": "R883220",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FAMILY NURSE PRACTITIONER",
            "identifier": "F0612635",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Ann Moore, PHD, LCSW
• Georganna Moore, FNP
• Jenna Moore, MS, RD, LD
• Jennifer Rebecca Moore, A.T., C., M.ED.
• Kenyata Renarda Moore, M.S.
• Morgan Moore, PT, DPT
• Rodney R Moore, MD
• Sarah V. Moore, CNP
• Tamara Moore, CMHT
• Tante Moore, NP-C

• Family Nurse Practitioner in Oxford, MS
• Providers in Oxford, 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 Sep 20, 2023; 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.