Jacinta L Moore, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN334179 Issued in GA

Practice address

368 McKenzie Dr
Stockbridge, GA 30281-6702

Phone

(910) 723-2381

Fax

(910) 723-2381

NPI assigned

Apr 16, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Jacinta Ingram Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Peach Health Concierge

  • Multi-Specialty Clinic/Center
  • Stockbridge, GA
  • NPI 1811860182
  NPD Authorized official
• Gatewood Clinic and Medspa LLC

  • Clinical Genetics (M.D.) Physician
  • Stone Mountain, GA
  • NPI 1871398842
  NPD (past)

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

{
    "created_epoch": "1744761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1922894955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "368 MCKENZIE DR",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302816702",
            "telephone_number": "910-723-2381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "368 MCKENZIE DR",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302816702",
            "telephone_number": "910-723-2381",
            "fax_number": "910-723-2381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JACINTA",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-04-16",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN334179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACINTA",
            "last_name": "INGRAM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sheree C. Montgomery, PT, DPT
• Shamara Moody, LPC, DCC
• Steven Allen Moon Jr., DNP
• Breauna Moore, RN
• Candace Renata Moore, CCC,SLP
• Mackenzie Moore
• Tyleka Moore
• Wafiyyah Moore
• Xavier C Moore, MD
• Brenda Maria Morales-Pico, MD

• Family Nurse Practitioner in Stockbridge, GA
• Providers in Stockbridge, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2025; 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.