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MARY KATE MOORE APRN, FNP-BC
NPI 1457793382
Nurse Practitioner - Family in Jacksboro, TN

Active since July 19, 2013PECOS Enrolled
2707 JACKSBORO PIKE, SUITE 1A, JACKSBORO, TN 37757(423) 907-8186(423) 907-8187 Get Directions Write a Review

NPPES record last updated: October 4, 2013. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Mary Kate Moore Aprn, Fnp-bc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARY KATE MOORE APRN, FNP-BC (NPI 1457793382) is an individual family provider in Jacksboro, Tennessee, licensed in Tennessee (17793) and active in the NPI registry since July 2013. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1457793382
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMARY KATE MOORECredential: APRN, FNP-BC
Location Address2707 JACKSBORO PIKE, SUITE 1AJacksboro, TN 37757-2752
Mailing Address1409 Bruce Gap RdCaryville, TN 37714-3832
Phone(423) 907-8186
Fax(423) 907-8187
Sole ProprietorNo
Enumeration DateJuly 19, 2013
Last NPPES UpdateOctober 4, 2013
✔ NPI 1457793382 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in TN · 17793
2707 JACKSBORO PIKE, Jacksboro, TN 37757
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mary Kate Moore Aprn, Fnp-bc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Mary Moore reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Renovation Health And Wellness
Same address
Family Health
2707 JACKSBORO PIKE, SUITE 1A
Jacksboro, TN 37757
  • Reassigned Medicare billing, Tennessee enrollment
  • 4 clinicians in this Medicare group
NPI 1336561943 (423) 907-8186
Minuteclinic Diagnostic Of Tennessee PC
148 mi
Family
3715 HILLSBORO RD
Nashville, TN 37215
  • Reassigned Medicare billing, Tennessee enrollment
  • 123 clinicians in this Medicare group
NPI 1457323164 (866) 389-2727

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 37757 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$81.53 typical visit price
range $52.64 – $160.89
Typical copayment $20.38 (range $13.16 – $40.22)
Most-billed visit code 99203
Established Patient
$93.60 typical visit price
range $16.72 – $131.41
Typical copayment $23.40 (range $4.18 – $32.85)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RENOVATION HEALTH AND WELLNESS
Clinical Nurse Specialist (Family Health)
2707 JACKSBORO PIKE, SUITE 1A
JACKSBORO, TN 37757
Campbell County (423) 907-8186
DR. DANNY KEITH TACKETT DMD
Dentist
2707 JACKSBORO PIKE, SUITE #4
JACKSBORO, TN 37757
Campbell County (423) 566-0401
JACKSBORO URGENT CARE
Clinic/Center (Urgent Care)
2707 JACKSBORO PIKE, SUITE 2
JACKSBORO, TN 37757
Campbell County (423) 907-8186

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 Mary Moore's NPI number?

The NPI number for Mary Moore is 1457793382. It was assigned to this individual provider in the NPPES registry on July 19, 2013.

Where is Mary Moore located?

Mary Moore practices at 2707 Jacksboro Pike Suite 1A, Jacksboro, TN 37757. The listed phone number is (423) 907-8186.

What is Mary Moore's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Mary Moore enrolled in Medicare?

Yes. Mary Moore is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Mary Moore's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mary Moore reassigns Medicare benefits to 2 organizations: Renovation Health And Wellness (Jacksboro, TN) and Minuteclinic Diagnostic Of Tennessee PC (Nashville, TN). Each 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 Mary 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 Mary Moore was last updated on October 4, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years 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.