Jasmine Marie Moore

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

9475967 Issued in FL

Practice address

3400 N 29TH Ave
Hollywood, FL 33020-1002

Phone

(954) 276-3400

NPI assigned

Nov 30, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jmoore304823@mhsdirect.net

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.

• Metamorphosis Psychcierge LLC

  • Adult Mental Health Clinic/Center
  • Fort Lauderdale, FL
  • NPI 1528794807
  NPD Authorized official

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

{
    "created_epoch": "1638230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658966400000",
    "number": "1669130381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2180 WILLIAM S. WHITE BUILDING",
            "address_2": "303 E KEARSLEY STREET",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485021950",
            "telephone_number": "810-762-3420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 N 29TH AVE",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330201002",
            "telephone_number": "954-276-3400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2180 William S. White Building",
            "address_2": "303 E Kearsley Street",
            "address_purpose": "LOCATION",
            "city": "Flint",
            "state": "MI",
            "postal_code": "48502",
            "country_code": "US",
            "telephone_number": "810-762-3420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JASMINE",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-30",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704318940",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9475967",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "9475967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "roshelen@umich.edu",
            "affiliation": "N",
            "address_1": "2180 William S. White Building",
            "address_2": "303 E Kearsley Street",
            "city": "Flint",
            "state": "MI",
            "country_code": "US",
            "postal_code": "48502",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Monica Montoto
• Franklin S Montoya
• Vanessa Dolores Montoya, MS, CCC-SLP
• Caitlin Moody
• Moonlight Orthotics LLC
• Julian O'Neil Moore
• Monica Moore, C.N.A, H.H.A
• Terri F Moore
• Noel J Mora, MD
• Yanely Mora, RBT-25-440383

• Psychiatric/Mental Health Nurse Practitioner in Hollywood, FL
• Providers in Hollywood, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.