ANDREA DIANE MOORE FNP-BC
NPI 1710645544
Nurse Practitioner - Family in Jacksonville, IL
About Andrea Diane Moore Fnp-bc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ANDREA DIANE MOORE FNP-BC (NPI 1710645544) is an individual family provider in Jacksonville, Illinois, licensed in Illinois (2021039559) and active in the NPI registry since November 2021. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Andrea Diane Moore Fnp-bc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 62650 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 3
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Andrea Moore's NPI number?
The NPI number for Andrea Moore is 1710645544. It was assigned to this individual provider in the NPPES registry on November 29, 2021.
Where is Andrea Moore located?
Andrea Moore practices at 425 E State St, Jacksonville, IL 62650. The listed phone number is (217) 408-1195.
What is Andrea Moore's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Andrea Moore enrolled in Medicare?
Yes. Andrea Moore is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Andrea Moore was last updated on January 9, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.
# Andrea Diane Moore, FNP-BC · NPI 1710645544
Family physician in Jacksonville, Illinois. Individual provider, active in the CMS NPPES registry since November 29, 2021.
## Identity
- **NPI:** 1710645544 (Entity type: Individual)
- **Enumerated:** November 29, 2021
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 2021039559 (Illinois)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 425 E STATE ST, Jacksonville, IL 62650-2125
- **Phone:** (217) 408-1195
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** January 9, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1710645544) · Data from the CMS NPPES public registry.