Mrs Nicole Jones Moore, NP is a medicare enrolled "Nurse Practitioner - Family" in Moselle, Mississippi. She graduated from nursing school in 2018 and has 6 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice David B Roy Do Pa and her current practice location is
3 John Everett Rd, Moselle, Mississippi. You can reach out to her office (for appointments etc.) via phone at
(251) 753-9148.
Mrs Nicole Jones Moore is licensed to practice in Mississippi (license number 903302) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1245890144.
Provider's Profile
| Full Name | Mrs Nicole Jones Moore |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 6 Years |
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| Location | 3 John Everett Rd, Moselle, Mississippi |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Mrs Nicole Jones Moore graduated from nursing school in 2018
NPI Data:
- NPI Number: 1245890144
- Provider Enumeration Date: 06/13/2019
- Last Update Date: 06/13/2019
Medicare PECOS Information:
- PECOS PAC ID: 3577890102
- Enrollment ID: I20190806000316
Medical Identifiers
Medical identifiers for Mrs Nicole Jones Moore such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1245890144 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | 903302 (Mississippi) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| David B Roy Do Pa | 2365767118 | 12 |
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 Nicole Jones Moore allows following entities to bill medicare on her behalf.
| Entity Name | David B Roy Do Pa |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1194124834
PECOS PAC ID: 2365767118
Enrollment ID: O20150219000500 |
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| Entity Name | Grayson Creek Medical Clinic Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1184166035
PECOS PAC ID: 1153605233
Enrollment ID: O20170309001847 |
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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. Mrs Nicole Jones 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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Mrs Nicole Jones Moore, NP
16 Riviera Cir,
Hattiesburg, MS 39402-8682
Ph: () - | Mrs Nicole Jones Moore, NP
3 John Everett Rd,
Moselle, MS 39459-9771
Ph: (251) 753-9148 |
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