Individual provider Active NPI

Jennifer Leigh Moore, CRNA

  • Certified Registered Nurse Anesthetist
National Provider Identifier
1801880091
Registry record updated Jul 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
ARNP9277203 Issued in FL
Practice address
PSC 827
Fpo, AE 09617
Phone
011390814324
NPI assigned
Sep 2, 2005
Last updated
Jul 10, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RNA36612 RI
Certified Registered Nurse Anesthetist 367500000X ARNP9277203 FL Primary

Addresses

Primary practice location

PSC 827
Fpo, AE 09617

Mailing address

1818 Roscoe Turner TRL
Port Orange, FL 32128-6838

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090217000110 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 0244395796 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Guide Anesthesia FL LLCGroup PAC ID 5698273142, 32 clinicians

Practice addresses (Care Compare)

541 Health Blvd
Daytona Beach, FL 32114-1493
Phone (386) 239-0021

Merit-based Incentive Payment System (MIPS)

Final score
94.8 of 100Reported as group
Quality
99.47
Improvement activities
40
Cost
83.62

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RNA36612RIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Amsurg Port Orange Anesthesia, LLC CurrentSince Mar 12, 2024 Accepting new patients
Guide Anesthesia FL LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 3, 2025 Accepting new patients
US Anesthesia Partners of Florida Inc. Nurse Anesthetist, Certified Registered CurrentSince Mar 7, 2024 Accepting new patients
Innovative Medical Staffing Solutions Inc Nurse Anesthetist, Certified Registered CurrentSince Nov 3, 2025 Accepting new patients

Locations

4600 E Washington St
Ste 300
Phoenix, AZ 85034
Phone (602) 638-1872

107 Park Place Blvd
Davenport, FL 33837
Phone (863) 419-2812

107 Park Place Blvd
Ste 800
Davenport, FL 33837

541 Health Blvd
Daytona Beach, FL 32114
Phone (386) 239-0021

3650 NW 82nd Ave
Ste 101
Doral, FL 33166
Phone (305) 341-7280

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

905 N John Young Pkwy
Kissimmee, FL 34741
Phone (407) 256-0933

401 Palmetto St
New Smyrna Beach, FL 32168
Phone (386) 424-5000

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

300 Clyde Morris Blvd
Ste B
Ormond Beach, FL 32174
Phone (386) 672-1080

345 Clyde Morris Blvd
Ste 300
Ormond Beach, FL 32174
Phone (386) 672-7575

3635 Clyde Morris Blvd
Ste 500
Port Orange, FL 32129
Phone (386) 760-8151

1000 Waterman Way
Tavares, FL 32778
Phone (352) 253-3333

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1125619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215648000000",
    "number": "1801880091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1818 ROSCOE TURNER TRL",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321286838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "MIL",
            "address_1": "PSC 827",
            "city": "FPO",
            "state": "AE",
            "postal_code": "09617",
            "telephone_number": "011390814324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JENNIFER",
        "middle_name": "LEIGH",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-02",
        "last_updated": "2008-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "RI",
            "license": "RNA36612",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP9277203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.