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SIMONE SHARDAE WILLIAMS MOORE MD
NPI 1730602806
Pediatrics in Mound Bayou, MS

Active since July 20, 2017PECOS Enrolled
702 MARTIN LUTHER KING ST, MOUND BAYOU, MS 38762(662) 741-8800(662) 741-8925 Get Directions Write a Review

NPPES record last updated: August 13, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Aug 13, 2025, Aug 6, 2025, Jan 8, 2025 and 2 more (5 updates tracked since 2017).

About Simone Shardae Williams Moore Md NPPES

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

SIMONE SHARDAE WILLIAMS MOORE MD (NPI 1730602806) is an individual pediatrics provider in Mound Bayou, Mississippi, licensed in Mississippi (27978) and active in the NPI registry since July 2017. She is enrolled in Medicare PECOS and maintains a secondary practice location in Jackson.

NPPES Registry Identity

NPI1730602806
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameSIMONE SHARDAE WILLIAMS MOORECredential: MD
Location Address702 MARTIN LUTHER KING STMound Bayou, MS 38762-9314
Mailing Address702 Martin Luther King StMound Bayou, MS 38762-9314 · (662) 741-8902
Phone(662) 741-8800
Fax(662) 741-8925
Sole ProprietorNo
Enumeration DateJuly 20, 2017
Last NPPES UpdateAugust 13, 20255 updates tracked since enumeration
NPPES CertifiedAugust 13, 2025
✔ NPI 1730602806 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in MS · 27978
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
702 MARTIN LUTHER KING ST, Mound Bayou, MS 38762
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Other Names 1

Former Name (1)Simone Shardae Williams

Secondary Practice Location 1

Location 12500 N State StJackson, MS 39216-4500 · Phone (601) 984-5200 · Fax (601) 984-5200

Other Identifiers 1

Medicaid04501349MS

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Simone Shardae Williams 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.

Medicare Billing Reassignment

Medicare enrollment records show Simone Moore reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Delta Health Center Inc
0.9 mi
Federally Qualified Health Center (FQHC)
702 MARTIN LUTHER KING ROAD
Mound Bayou, MS 38762
  • Reassigned Medicare billing, Mississippi enrollment
  • 28 clinicians in this Medicare group
NPI 1659378610 (662) 741-2151

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 38762 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
$80.50 typical visit price
range $51.65 – $159.18
Typical copayment $20.12 (range $12.91 – $39.79)
Most-billed visit code 99203
Established Patient
$92.20 typical visit price
range $16.15 – $129.61
Typical copayment $23.05 (range $4.03 – $32.40)
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 20

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

CAROL MACK LCSW
Social Worker
702 MARTIN LUTHER KING ST
MOUND BAYOU, MS 38762
Bolivar County (662) 741-2151
DAFFANY WILLIAMS PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
702 MARTIN LUTHER KING ST
MOUND BAYOU, MS 38762
Bolivar County (662) 741-8800
DR. CAROLYN EUBANKS DMD
Dentist
702 MARTIN LUTHER KING ST
MOUND BAYOU, MS 38762
Bolivar County (662) 741-2151
DELTA HEALTH CENTER, INC
Home Health
702 MARTIN LUTHER KING ST
MOUND BAYOU, MS 38762
Bolivar County (662) 741-2906
DR. ANTHONY LOUIS OLIVERI
Physical Medicine & Rehabilitation
702 MARTIN LUTHER KING ST
MOUND BAYOU, MS 38762
Bolivar County (662) 741-8800
MISS AMEE RENEE WEST PTA
Physical Therapy Assistant
702 MARTIN LUTHER KING ST
MOUND BAYOU, MS 38762
Bolivar County (662) 741-8800
DELTA HEALTH CENTER
Clinic/Center (Federally Qualified Health Center (FQHC))
702 MARTIN LUTHER KING ST
MOUND BAYOU, MS 38762
Bolivar County (662) 741-2151
NATURAL PAIN BACK INSTITUTE, LLC
Chiropractor (Internist)
702 MARTIN LUTHER KING ST
MOUND BAYOU, MS 38762
Bolivar County (662) 741-2151

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 Simone Moore's NPI number?

The NPI number for Simone Moore is 1730602806. It was assigned to this individual provider in the NPPES registry on July 20, 2017. The provider is also known as Simone Shardae Williams.

Where is Simone Moore located?

Simone Moore practices at 702 Martin Luther King St, Mound Bayou, MS 38762. The listed phone number is (662) 741-8800.

What is Simone Moore's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Simone Moore enrolled in Medicare?

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

Which organization bills Medicare for Simone Moore's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Simone Moore reassigns Medicare benefits to Delta Health Center Inc (Mound Bayou, MS). 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 Simone Moore's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Simone Moore accept?

Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter of Alabama and Ambetter of Tennessee and 2 other insurers list Simone Moore as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Simone Moore was last updated on August 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.