Individual provider Active NPI

Jessica Morgan Moore

  • Acute Care Nurse Practitioner
  • Adairsville, GA
National Provider Identifier
1568128809
Registry record updated Oct 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
220464 Issued in GA
Practice address
171 Hardwood Ridge Dr
Adairsville, GA 30103-2018
Phone
(404) 309-3441
NPI assigned
Nov 10, 2021
Last updated
Oct 20, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 220464 GA Primary

Addresses

Primary practice location

171 Hardwood Ridge Dr
Adairsville, GA 30103-2018

Mailing address

171 Hardwood Ridge Dr
Adairsville, GA 30103-2018
Phone (404) 309-3441

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
I20221028001625 GA Practitioner - Nurse Practitioner 4981071271 Reassigns benefits to 2 organizations

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
Floyd Healthcare Management IncGroup PAC ID 5193633386, 133 clinicians

Practice addresses (Care Compare)

1650 Chattahoochee Dr
Rockmart, GA 30153-2023
Phone (770) 684-7846

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.9 of 100Reported as group
Promoting interoperability
97
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
220464GAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Floyd Healthcare Management Inc CurrentSince Oct 1, 2022 Accepting new patients
Floyd Healthcare Management Inc CurrentSince Oct 1, 2022 Accepting new patients

Locations

1025 N Main St
Cedartown, GA 30125
Phone (770) 748-5212

1650 Chattahoochee Dr
Rockmart, GA 30153
Phone (770) 684-6100

420 E 2nd Ave
Ste 103
Rome, GA 30161
Phone (706) 509-3278

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.

Hospital & facility affiliations 1

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": "1636502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666224000000",
    "number": "1568128809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 HARDWOOD RIDGE DR",
            "city": "ADAIRSVILLE",
            "state": "GA",
            "postal_code": "301032018",
            "telephone_number": "404-309-3441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 HARDWOOD RIDGE DR",
            "city": "ADAIRSVILLE",
            "state": "GA",
            "postal_code": "301032018",
            "telephone_number": "404-309-3441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JESSICA",
        "middle_name": "MORGAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-10",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "GA",
            "license": "220464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Adairsville, GA

Sources for this page

Verify at the official NPI Registry.