Jennifer Evans Moore, NP is a medicare enrolled "Nurse Practitioner - Family" in Vass, North Carolina. Her current practice location is
3349 Us 1 Hwy, Vass, North Carolina. You can reach out to her office (for appointments etc.) via phone at
(910) 245-7678.
Jennifer Evans Moore is licensed to practice in North Carolina (license number 5017869) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1053015255.
Provider's Profile
| Full Name | Jennifer Evans Moore |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | 3349 Us 1 Hwy, Vass, North Carolina |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1053015255
- Provider Enumeration Date: 03/30/2023
- Last Update Date: 03/30/2023
Medicare PECOS Information:
- PECOS PAC ID: 9638534118
- Enrollment ID: I20230505001905
Medical Identifiers
Medical identifiers for Jennifer Evans Moore such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1053015255 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | 5017869 (North Carolina) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Jennifer Evans Moore allows following entities to bill medicare on her behalf.
| Entity Name | Fhpg Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1336154129
PECOS PAC ID: 9537481569
Enrollment ID: O20141202002644 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jennifer Evans Moore is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Jennifer Evans Moore, NP
3349 Us 1 Hwy,
Vass, NC 28394
Ph: (910) 245-7678 | Jennifer Evans Moore, NP
3349 Us 1 Hwy,
Vass, NC 28394
Ph: (910) 245-7678 |
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