Nicole Moore, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4704230526 Issued in MI

Practice address

1014 Sixth St Ste 101
Traverse City, MI 49684-2398

Phone

(231) 421-6921

Fax

(231) 421-7852

NPI assigned

Sep 26, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA, IL2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Genesis Health SystemGroup PAC ID 6103829338, 262 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Genesis Medical Center-Davenport Hospital, Davenport, IA, CCN 160033
• Genesis HLTH System Dba Genesis MDL Ctr-Illini Hospital, Silvis, IL, CCN 140275

Merit-based Incentive Payment System (MIPS)

Final score

34.85 of 100Reported as group

Quality

21.4

Improvement activities

0

Cost

76.92

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Genesis Health System

  • Surgery Physician
  • Davenport, IA
  • NPI 1528616901
  Medicare reassignment Care Compare group NPD
• Genesis Health System

  • General Acute Care Hospital
  • Silvis, IL
  • NPI 1427132604
  Medicare reassignment NPD
• Genesis Health System

  • Family Medicine Physician
  • Moline, IL
  • NPI 1164538435
  NPD (past)

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

• Genesis Health System

  • General Acute Care Hospital
  • Silvis, IL
  • NPI 1427132604
  Care Compare affiliation
• Genesis Health System

  • General Acute Care Hospital
  • Davenport, IA
  • NPI 1972542264
  Care Compare affiliation

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

{
    "created_epoch": "1443225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443225600000",
    "number": "1558731075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1014 SIXTH ST STE 101",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842398",
            "telephone_number": "231-421-6921",
            "fax_number": "231-421-7852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1014 SIXTH ST STE 101",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842398",
            "telephone_number": "231-421-6921",
            "fax_number": "231-421-7852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "NICOLE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-26",
        "last_updated": "2015-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704230526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan Moore, M.S. ED
• Julie L Moore, PA-C
• Kaitlyn Marie Moore
• Kimberly Moore
• Michelle Annette Moore
• Re'Onna Moore
• Moran Health System Inc
• Christopher A Moran, DC
• Kelly Ann Moran
• Janet Margaret Morency, M.A.

• Nurse Practitioner in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2015; 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.