Angela Victoria Moore, MSN, FNP-C, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

4704290287 Issued in MI

Practice address

850 W Baraga Ave
Marquette, MI 49855-4550

Phone

(906) 449-1600

NPI assigned

Oct 14, 2021

Last updated

Nov 18, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Keweenaw Bay Indian CommunityGroup PAC ID 7315070471, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: angela.moore.1@8233.direct.athenahealth.com

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.

• DLP Marquette Physician Practices Inc

  dba Marquette General Family Medicine - Marquette

  • Obesity Medicine (Internal Medicine) Physician
  • Marquette, MI
  • NPI 1487902995
  Medicare reassignment NPD
• Pathways

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Marquette, MI
  • NPI 1487683546
  Medicare reassignment NPD
• Superior Walk-in Center, PC

  • Family Medicine Physician
  • Marquette, MI
  • NPI 1497806418
  Medicare reassignment NPD
• Keweenaw Bay Indian Community

  • Federally Qualified Health Center (FQHC)
  • Baraga, MI
  • NPI 1336232289
  Care Compare group
• DLP Marquette Physician Practices Inc

  dba UP Health System Pediatric Specialists

  • Rural Health Clinic/Center
  • Marquette, MI
  • NPI 1205635760
  NPD
• Superior Walk-in Center, PC

  • Family Medicine Physician
  • Munising, MI
  • NPI 1669575148
  NPD
• Superior Walk-in Center, PC

  dba Superior Walk-In & Family Health

  • Family Medicine Physician
  • Marquette, MI
  • NPI 1992167241
  NPD

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

{
    "created_epoch": "1634169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1861155178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 RYAN AVE APT 4",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498551281",
            "telephone_number": "586-202-3763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 W BARAGA AVE",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498554550",
            "telephone_number": "906-449-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ANGELA",
        "middle_name": "VICTORIA",
        "credential": "MSN, FNP-C, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-14",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704290287",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704290287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer K Mogan, RN
• Natalie K Molnau, BEHAVIOR TECHNICIAN
• Monarch Healthcare (Monarch Mental Healthcare)
• Monica L. Nordeen, LMSW
• Francois Montbrun, DC
• Marguerite Theresa Moore, PH.D, ATC
• Bridget Michele Moran, LLMSW
• Ashley Morey
• Legaci Morgan, LLMSW
• Debra J Morley, MD

• Psychiatric/Mental Health Nurse Practitioner in Marquette, MI
• Providers in Marquette, MI by specialty
• Psychiatric/Mental Health Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.