Individual provider Active NPI

Ba'Sharra Aneka Moore, NP

  • Adult Health Nurse Practitioner
  • Macon, GA
National Provider Identifier
1518682186
Registry record updated Mar 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
RN252151 Issued in GA
Practice address
890 2ND St Ste 201
Macon, GA 31201-6863
Phone
(478) 745-4322
Fax
(478) 254-3629
NPI assigned
Oct 6, 2022
Last updated
Mar 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X RN252151 GA Primary
Nephrology Registered Nurse 163WN0300X RN252151 GA

Addresses

Primary practice location

890 2ND St Ste 201
Macon, GA 31201-6863

Mailing address

890 2ND St Ste 201
Macon, GA 31201-6863
Phone (478) 745-4322

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
I20230518000386 GA Practitioner - Nurse Practitioner 3173989118 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Hemlock Pain Center, LLC.Group PAC ID 8224076997, 4 clinicians

Practice addresses (Care Compare)

101 Preston CT
Suite 103
Macon, GA 31210-5771
Phone (478) 745-2385

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Hemlock Pain Center, LLC CurrentSince Apr 1, 2024 Accepting new patients
The Hemlock Pain Center, LLC Current Accepting new patients
The Hemlock Pain Center, LLC Past Accepting new patients

Locations

202 Fairview Park Dr
Ste 100
Dublin, GA 31021

101 Preston Ct
Ste 103
Macon, GA 31210
Phone (478) 745-2385

750 N Cobb St
Ste 150
Milledgeville, GA 31061
Phone (478) 284-0670

200 S Houston Lake Rd
Ste A
Warner Robins, GA 31088
Phone (478) 971-1080

312 Margie Dr
Warner Robins, GA 31088
Phone (478) 272-2707

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JFHCAA

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1665014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677801600000",
    "number": "1518682186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "890 2ND ST STE 201",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312016863",
            "telephone_number": "478-745-4322",
            "fax_number": "478-254-3629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 2ND ST STE 201",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312016863",
            "telephone_number": "478-745-4322",
            "fax_number": "478-254-3629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "BA'SHARRA",
        "middle_name": "ANEKA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-06",
        "last_updated": "2023-03-03",
        "certification_date": "2023-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "RN252151",
            "primary": true
        },
        {
            "code": "163WN0300X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Nephrology",
            "state": "GA",
            "license": "RN252151",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.