MRS. JACQUELINE MOORE FNP-C
NPI 1033611256
Nurse Practitioner - Family in Monticello, MS
About Mrs. Jacqueline Moore Fnp-c NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MRS. JACQUELINE MOORE FNP-C (NPI 1033611256) is an individual family provider in Monticello, Mississippi, licensed in Mississippi (902473) and active in the NPI registry since March 2018. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses 2
Other Identifiers 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mrs. Jacqueline Moore Fnp-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Jacqueline Moore reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Nashville, TN 37219
- Reassigned Medicare billing, Mississippi enrollment
- 195 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 39654 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
MONTICELLO, MS 39654
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Jacqueline Moore's NPI number?
The NPI number for Jacqueline Moore is 1033611256. It was assigned to this individual provider in the NPPES registry on March 3, 2018.
Where is Jacqueline Moore located?
Jacqueline Moore practices at 314 Main St Ste D, Monticello, MS 39654. The listed phone number is (601) 587-4304.
What is Jacqueline Moore's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Jacqueline Moore enrolled in Medicare?
Yes. Jacqueline Moore is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Jacqueline Moore's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jacqueline Moore reassigns Medicare benefits to Community Care Health Network LLC (Nashville, TN). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jacqueline Moore's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Jacqueline Moore was last updated on September 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 45 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Mrs. Jacqueline Moore, FNP-C · NPI 1033611256
Family physician in Monticello, Mississippi. Individual provider, active in the CMS NPPES registry since March 3, 2018.
## Identity
- **NPI:** 1033611256 (Entity type: Individual)
- **Enumerated:** March 3, 2018
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 902473 (Mississippi)
- **Sole proprietor:** No
## Practice location
- **Address:** 314 MAIN ST STE D, Monticello, MS 39654-3702
- **Phone:** (601) 587-4304
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Community Care Health Network LLC (NPI 1619368842, Nashville, TN), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 29, 2026
- **Other identifiers:** Medicaid 902473 (MS); Other 902473 (MS)
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Source: [NPI Profile](https://npiprofile.com/npi/1033611256) · Data from the CMS NPPES public registry.