Individual provider Active NPI

Rebecca McWhorter Moore, CPNP

  • Nurse Practitioner
  • Cartersville, GA
National Provider Identifier
1699823302
Registry record updated Apr 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN137979 Issued in GA
Practice address
200 Gentilly Blvd
Cartersville, GA 30120-8504
Phone
(470) 490-6860
Fax
(678) 721-9457
NPI assigned
Jan 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN137979 GA Primary

Addresses

Primary practice location

200 Gentilly Blvd
Cartersville, GA 30120-8504

Mailing address

221 Technology Pkwy NW
Rome, GA 30165-1369
Phone (762) 235-1000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rebecca.moore.1@1498.direct.athenahealth.com

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
I20160210000548 GA Practitioner - Nurse Practitioner 4587968631 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Harbin Clinic, LLC Current Accepting new patients
Harbin Clinic, LLC CurrentSince Apr 11, 2022 Accepting new patients
Harbin Clinic, LLC CurrentSince Apr 11, 2022 Accepting new patients
Agc Pediatrics, LLC Pediatrics Past Accepting new patients
Agc Pediatrics, LLC PastSince Sep 23, 2019 Accepting new patients

Locations

200 Gentilly Blvd
Cartersville, GA 30120
Phone (470) 490-6860

1825 Martha Berry Blvd NW
Rome, GA 30165
Phone (706) 238-8073

221 Technology Pkwy NW
Rome, GA 30165
Phone (762) 235-1000

101 Redmond Rd NW
Rome, GA 30165
Phone (706) 290-1330

Interoperability endpoints

  • Direct secure messaging: rmoore3004804@carolinashealthcaresystem.direct-ci.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/DEJAAA
  • Direct secure messaging: rebecca.moore.1@1498.direct.athenahealth.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648771200000",
    "number": "1699823302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 TECHNOLOGY PKWY NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651369",
            "telephone_number": "762-235-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 GENTILLY BLVD",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301208504",
            "telephone_number": "470-490-6860",
            "fax_number": "678-721-9457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "REBECCA",
        "middle_name": "MCWHORTER",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2022-04-01",
        "certification_date": "2022-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN137979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rebecca.moore.1@1498.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "200 Gentilly Blvd",
            "city": "Cartersville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301208504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cartersville, GA

Sources for this page

Verify at the official NPI Registry.