Individual provider Active NPI

Nicole Moncrieffe

  • Family Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1487034666
Registry record updated Jun 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN181921 Issued in GA
Practice address
351 W Camden St
Baltimore, MD 21201-7912
Phone
(410) 625-2200
NPI assigned
Jun 3, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2015

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 RN181921 GA Primary

Addresses

Primary practice location

351 W Camden St
Baltimore, MD 21201-7912

Mailing address

1217 Preserve Park Dr
Loganville, GA 30052-5826
Phone (678) 756-2355

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
I20171005000095 GA Practitioner - Nurse Practitioner 3173898822 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Horizons HealthcareGroup PAC ID 3173524121, 3 clinicians

Practice addresses (Care Compare)

2795 Main St W
Suite 27
Snellville, GA 30078-3164
Phone (770) 985-8001

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN181921GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Horizons Healthcare CurrentSince Aug 22, 2017 Accepting new patients
Align Hospice Care,LLC CurrentSince Apr 20, 2024 Accepting new patients

Locations

2795 Main St W
#27
Snellville, GA 30078
Phone (770) 985-8001

2795 Main St W
Bldg 27
Snellville, GA 30078
Phone (770) 985-8001

Interoperability endpoints

  • Direct secure messaging: nmoncrieffe@hhc.curemd.direct-ci.com
  • Direct secure messaging: nicole.moncrieffe.p1@direct.alegiscare.nextgenshare.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Align Hospice Care, LLCSnellville, GA, CCN 851609 Hospice Contracted Managing Employee
5% Or Greater Direct Ownership Interest (50%)
May 20, 2024
Apr 20, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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.

NPI Registry JSON

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

{
    "created_epoch": "1433289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433289600000",
    "number": "1487034666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1217 PRESERVE PARK DR",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300525826",
            "telephone_number": "678-756-2355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 W CAMDEN ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212017912",
            "telephone_number": "410-625-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONCRIEFFE",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-03",
        "last_updated": "2015-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN181921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.