Individual provider Active NPI

Nakita Monique Moore, M.D.

  • Psychiatry Physician
  • Beaumont, TX
National Provider Identifier
1992950463
Registry record updated Mar 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
P1365 Issued in TX
Practice address
2750 S 8TH St
Beaumont, TX 77701-7719
Phone
(409) 839-1000
NPI assigned
Nov 24, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X P1365 TX Primary

Addresses

Primary practice location

2750 S 8TH St
Beaumont, TX 77701-7719

Mailing address

PO Box 14969
Houston, TX 77221-4969
Phone (832) 668-9103

Other practice location 1

7200 North Loop E
Houston, TX 77028-5951
Phone (713) 970-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120725001129 TX Practitioner - Psychiatry 0941466510 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
P1365TXMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Spindletop MHMR Services CurrentSince Jun 1, 2019 Accepting new patients
Spindletop MHMR Services CurrentSince Jun 1, 2019 Accepting new patients

Locations

2750 S 8th St
Beaumont, TX 77701
Phone (409) 838-6203

2895 S 8th St
Beaumont, TX 77701
Phone (409) 454-3355

Organizations & group practices 2

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": "1227484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648684800000",
    "number": "1992950463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14969",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772214969",
            "telephone_number": "832-668-9103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2750 S 8TH ST",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777017719",
            "telephone_number": "409-839-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7200 North Loop E",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770285951",
            "country_code": "US",
            "telephone_number": "713-970-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "NAKITA",
        "middle_name": "MONIQUE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-24",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "P1365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

Verify at the official NPI Registry.