Marquincio Moore, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

LPN104478 Issued in GA

Practice address

624 Forest Hill Rd Apt A1
Macon, GA 31210-4608

Phone

(478) 228-6269

NPI assigned

Dec 2, 2024

Last updated

Dec 2, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1733097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1689490138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 FOREST HILL RD APT A1",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312104608",
            "telephone_number": "478-228-6269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 FOREST HILL RD APT A1",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312104608",
            "telephone_number": "478-228-6269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MARQUINCIO",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-12-02",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "GA",
            "license": "LPN104478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah D Moore, PAC
• Elizabeth Moore, NP
• Harry Francis Moore Jr., M.D.
• Keshia Moore, R.N.
• Malcolm S Moore Jr., M.D.
• Matthew Benjamin Moore, MD
• Morgan Olivia Moore
• Sandra E Moore, MD
• Timothy Tyler Moore
• Vicki Moreno

• Licensed Practical Nurse in Macon, GA
• Providers in Macon, GA by specialty
• Licensed Practical Nurse in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; 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.