Rhonda Moore, AGPCNP-BC
Individual provider Active NPI Gerontology Nurse Practitioner · Union, MS
NPI 1669914826 · NPPES record last updated Jun 10, 2024
Key facts
- NPI
- 1669914826
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Gerontology Nurse Practitioner 363LG0600X
- License
- R871925 (MS)
- Practice address
- 24345 Highway 15
Union, MS 39365-8575 - Phone
- (601) 774-8211
- Fax
- (601) 774-8589
- NPI assigned
- Nov 4, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 23
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Laird Hospital, Inc.
Kemper Cah, Inc.
Practice addresses (Care Compare)
1106 Central Dr
Philadelphia, MS 39350-8972
Phone (601) 656-6921
24345 Hwy 15
Union, MS 39365-8575
Phone (601) 774-8211
4331 Hwy 39 N
Meridian, MS 39301-1007
Phone (601) 484-6180
Hospital & facility affiliations
- Accentcare Home Health of Carthage
- Ochsner Laird Hospital
- Neshoba County General Hospital
- Ochsner Rush Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170426000240 | MS | Practitioner - Nurse Practitioner | 1254618481 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R871925 | MS | MD | Gerontology Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rush Medical Foundation | Current |
Accepting new patients | |
| Kemper Cah, Inc | Current |
Accepting new patients | |
| Laird Hospital, Inc. | Current |
Accepting new patients | |
| Rush Medical Foundation | Current | Accepting new patients | |
| Medical Foundation, Inc. | Current |
Accepting new patients | |
| Kemper Cah, Inc. | Current | Accepting new patients | |
| Rush Medical Foundation | Current |
Accepting new patients | |
| Medical Foundation, Inc. | Current |
Accepting new patients | |
| Laird Hospital, Inc | Current |
Accepting new patients | |
| Laird Hospital, Inc. | Current | Accepting new patients | |
| Rush Medical Foundation | Past | Accepting new patients |
Locations
9097 Collinsville Rd
Collinsville, MS 39325
Phone (601) 626-8874
14365 Highway 16 W
De Kalb, MS 39328
Phone (769) 486-1000
5334 Dale Dr
Marion, MS 39342
Phone (601) 703-0130
1710 14th St
Meridian, MS 39301
Phone (601) 482-9211
1500 Highway 19 N
Meridian, MS 39307
Phone (601) 483-5353
1314 19th Ave
Meridian, MS 39301
Phone (601) 483-0011
4331 Highway 39 N
Meridian, MS 39301
Phone (601) 482-5735
2800 N Hills St
Meridian, MS 39305
Phone (601) 693-9906
2401 16th St
Meridian, MS 39301
Phone (601) 482-4181
1800 12th St
Meridian, MS 39301
Phone (601) 483-0011
603 S Archusa Ave
Quitman, MS 39355
Phone (601) 776-2123
24345 Highway 15
Union, MS 39365
Phone (601) 774-8211
25117 Highway 15
Union, MS 39365
Phone (601) 774-8214
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | R871925 | MS | Yes |
Addresses
Primary practice location
24345 Highway 15
Union, MS 39365-8575
Mailing address
24345 Highway 15
Union, MS 39365-8575
Phone (601) 747-8211
Other providers in Union, MS
- Laird Hospital, Inc.
- Melissa Loper
- Sheri Marie Luebrecht
- Danielle McDaniel
- Mississippi Em-I Medical Services PC
- Summer Henry Moore
- Carol Johnson Moseley
- Ms Eye Care PA
- Newton County LTC LLC
- Rebecca Claire Norsworthy
All providers in Union, MS · Gerontology Nurse Practitioner in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 10, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.