Mrs Jacqueline Moore, FNP-C in Monticello, MS

Mrs Jacqueline Moore, FNP-C is a medicare enrolled "Nurse Practitioner - Family" in Monticello, Mississippi. Her current practice location is 314 Main St Ste D, Monticello, Mississippi. You can reach out to her office (for appointments etc.) via phone at (601) 587-4304.

Mrs Jacqueline Moore is licensed to practice in Mississippi (license number 902473) 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 1033611256.

Contact Information

	Mrs Jacqueline Moore, FNP-C
	314 Main St Ste D, Monticello, MS 39654-3702
	(601) 587-4304
	Not Available

Map and Direction

Provider's Profile

Full Name	Mrs Jacqueline Moore
Gender	Female
Speciality	Nurse Practitioner - Family
Location	314 Main St Ste D, Monticello, Mississippi
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1033611256
Provider Enumeration Date: 03/03/2018
Last Update Date: 12/06/2021

Medicare PECOS Information:

PECOS PAC ID: 2365830692
Enrollment ID: I20211019002039

Medical Identifiers

Medical identifiers for Mrs Jacqueline Moore such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1033611256	NPI	-	NPPES
902473	Other	MS	FNP LICENSE
902473	Medicaid	MS

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
163W00000X	Registered Nurse	859952 (Mississippi)	Secondary
363LF0000X	Nurse Practitioner - Family	902473 (Mississippi)	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. Mrs Jacqueline Moore allows following entities to bill medicare on her behalf.

Entity Name	Community Care Health Network Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1619368842 PECOS PAC ID: 8527324151 Enrollment ID: O20210520000556

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. Mrs Jacqueline 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
Mrs Jacqueline Moore, FNP-C 1314 Zetus Rd Nw, Brookhaven, MS 39601-8309 Ph: (601) 757-5621	Mrs Jacqueline Moore, FNP-C 314 Main St Ste D, Monticello, MS 39654-3702 Ph: (601) 587-4304

Reviews and Comments

Nurse Practitioner Nurses in Monticello, MS

Mrs. Rebecca Hussey Burris, C.F.N.P. Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 827 F. E. Sellers Highway, Monticello, MS 39654 Phone: 601-587-4648 Fax: 601-587-0613
Becky Jan Mercier, RN, CFNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1065 E Broad St, Monticello, MS 39654 Phone: 601-587-4051 Fax: 601-587-1256
Molly Grubbs Mayhugh, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 314 Main St Ste D, Monticello, MS 39654 Phone: 601-587-4304 Fax: 601-587-4515
Genie B Vaughan, RN, CFNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1065 E Broad St, Monticello, MS 39654 Phone: 601-587-4051 Fax: 601-587-1256
Rhonda Joyce Thomas, FNP-C, ACNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1065 E Broad St, Monticello, MS 39654 Phone: 601-587-4051 Fax: 601-587-1256
Tonjia S Lang, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 4739 Highway 587, Monticello, MS 39654 Phone: 601-695-3745
Teresa Conerly, NPC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 430 W Broad St, Monticello, MS 39654 Phone: 601-825-7280 Fax: 601-825-8130

Mrs Jacqueline Moore, FNP-C - Medicare Nurse Practitioner in Monticello, MS