Jodi-Ann Camille Moore, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

9 Medical Dr NE Ste E
Cartersville, GA 30121-8003

Phone

(470) 227-1600

Fax

(470) 227-1606

NPI assigned

Aug 11, 2008

Last updated

May 27, 2021By 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 3

Addresses

Electronic endpoints 1

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

Specialty

Physician Assistant

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Douglas Dermatology and Skin Cancer Specialists LLCGroup PAC ID 1658680764, 9 clinicians

Metroderm, P.C.Group PAC ID 8729076443, 33 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jodiann.moore@sccdc.gadirect.net

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.

• Metroderm, P.C.

  • MOHS-Micrographic Surgery Physician
  • Atlanta, GA
  • NPI 1205833894
  Medicare reassignment Care Compare group NPD
• Douglas Dermatology and Skin Cancer Specialists LLC

  • Dermatology Physician
  • Douglasville, GA
  • NPI 1275929267
  Medicare reassignment Care Compare group
• Metroderm, P.C.

  • Specialist
  • Gainesville, GA
  • NPI 1942929062
  NPD
• Gwinnett Dermatology PC D/B/a Georgia Dermatology Partners

  • Dermatology Physician
  • Snellville, GA
  • NPI 1477596203
  NPD (past)
• Wesley S Wilborn MD PC

  dba Metro Atlanta Dermatology Group

  • Dermatology Physician
  • Atlanta, GA
  • NPI 1750554978
  NPD (past)
• Skin Cancer and Cosmetic Dermatology Center PC

  • Dermatology Physician
  • Chattanooga, TN
  • NPI 1144419458
  NPD (past)

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

{
    "created_epoch": "1218412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622073600000",
    "number": "1962658963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 MEDICAL DR NE STE E",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301218003",
            "telephone_number": "470-227-1600",
            "fax_number": "470-227-1606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 MEDICAL DR NE STE E",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301218003",
            "telephone_number": "470-227-1600",
            "fax_number": "470-227-1606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JODI-ANN",
        "middle_name": "CAMILLE",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-11",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "005365",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "GA",
            "license": "005365",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jychung@directaddress.net",
            "affiliation": "Y",
            "affiliationName": "Skin Cancer & Cosmetic Dermatology Center, PC",
            "address_1": "1107 Memorial Drive",
            "address_2": "Suite 201",
            "city": "Dalton",
            "state": "GA",
            "country_code": "US",
            "postal_code": "30720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• William Moon, PH.D.
• Moore Essential Services LLC
• Moore Professional Counseling, LLC
• Carolyn O Moore
• Courtney King Moore, MS
• Racquel Denise Moore, MS
• Rebecca McWhorter Moore, CPNP
• Tikeisha L Moore
• Winfred F Moore, FNP-C
• Danielle Marie Morgan, M.S., CCC-SLP

• Physician Assistant in Cartersville, GA
• Providers in Cartersville, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2021; 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.