Individual provider Active NPI

Latrice Moore, FNP-BC

  • Nurse Practitioner
  • Leesburg, VA
National Provider Identifier
1518633122
Registry record updated Oct 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
0024182341 Issued in VA
Practice address
44045 Riverside Pkwy
Leesburg, VA 20176-5101
Phone
(703) 858-6000
NPI assigned
Aug 23, 2021
Last updated
Oct 25, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 0024182341 VA Primary

Addresses

Primary practice location

44045 Riverside Pkwy
Leesburg, VA 20176-5101

Mailing address

44045 Riverside Pkwy
Leesburg, VA 20176-5101
Phone (703) 858-8464

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20211112002594 VA Practitioner - Nurse Practitioner 1153710173 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Commonwealth Critical Care LLCGroup PAC ID 4284909029, 26 clinicians

Practice addresses (Care Compare)

44045 Rivderside Pkwy
Leesburg, VA 20176-5101
Phone (703) 858-6040

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Critical Care LLC CurrentSince Sep 8, 2021 Accepting new patients
Commonwealth Critical Care LLC Nurse Practitioner PastSince Jun 22, 2021 Accepting new patients

Locations

44045 Riverside Pkwy
Leesburg, VA 20176
Phone (703) 858-6040

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1629676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792886400000",
    "number": "1518633122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44045 RIVERSIDE PKWY",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201765101",
            "telephone_number": "703-858-8464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44045 RIVERSIDE PKWY",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201765101",
            "telephone_number": "703-858-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "LATRICE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-23",
        "last_updated": "2026-10-25",
        "certification_date": "2026-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024182341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, VA

Sources for this page

Verify at the official NPI Registry.