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MAKENNA ELISE MOORE MD
NPI 1629872049
Student in an Organized Health Care Education/Training Program in Hattiesburg, MS

Active since April 03, 2025PECOS Enrolled
6051 U S HIGHWAY 49, HATTIESBURG, MS 39401(601) 288-7000 Get Directions Write a Review

NPPES record last updated: April 3, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Makenna Elise Moore Md NPPES

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

MAKENNA ELISE MOORE MD (NPI 1629872049) is an individual student in an organized health care education/training program in Hattiesburg, Mississippi and active in the NPI registry since April 2025. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1629872049
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameMAKENNA ELISE MOORECredential: MD
Location Address6051 U S HIGHWAY 49Hattiesburg, MS 39401-7200
Mailing Address6051 U S Highway 49Hattiesburg, MS 39401-7200 · (601) 288-7000
Phone(601) 288-7000
Sole ProprietorNo
Enumeration DateApril 3, 2025
NPPES CertifiedApril 3, 2025
✔ NPI 1629872049 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
6051 U S HIGHWAY 49, Hattiesburg, MS 39401
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Makenna Elise Moore Md 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.

Other Providers at the Same Location NPPES 20

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

RAMATA SAKHANOKHO PHARM.D.
Pharmacist
6051 U S HIGHWAY 49
HATTIESBURG, MS 39401
Forrest County (601) 288-4213
KRISTI HILL NESLER PHARM.D.
Pharmacist
6051 U S HIGHWAY 49
HATTIESBURG, MS 39401
Forrest County (601) 288-4160
JUANICE GANDY GLAZE
Pharmacist
6051 U S HIGHWAY 49
HATTIESBURG, MS 39401
Forrest County (601) 288-4276
MELISSA RUTH TOLAR FNP
Nurse Practitioner (Family)
6051 U S HIGHWAY 49
HATTIESBURG, MS 39401
Forrest County (601) 288-1212
TIFFANY YVETTE BOONE NP
Nurse Practitioner
6051 U S HIGHWAY 49
HATTIESBURG, MS 39401
Forrest County (601) 264-6000
FGH PHYSICIAN BILLING
Internal Medicine (Cardiovascular Disease)
6051 U S HIGHWAY 49
HATTIESBURG, MS 39401
Forrest County (601) 288-7000
JACKLYN CUMMINS DO
Student in an Organized Health Care Education/Training Program
6051 U S HIGHWAY 49
HATTIESBURG, MS 39401
Forrest County (601) 288-7000
LEE PACE FNP, OTR
Nurse Practitioner (Family)
6051 U S HIGHWAY 49
HATTIESBURG, MS 39401
Forrest County (601) 288-7000

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 Makenna Moore's NPI number?

The NPI number for Makenna Moore is 1629872049. It was assigned to this individual provider in the NPPES registry on April 3, 2025.

Where is Makenna Moore located?

Makenna Moore practices at 6051 U S Highway 49, Hattiesburg, MS 39401. The listed phone number is (601) 288-7000.

What is Makenna Moore's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Makenna Moore enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Makenna Moore was last updated on April 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months 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.