MRS. NICOLE LYNN MOORE CRNP
NPI 1780021436
Nurse Practitioner - Family in Jacksonville, FL

Q: What is Nicole Moore's NPI number?

The NPI number for Nicole Moore is 1780021436. It was assigned to this individual provider in the NPPES registry on June 3, 2013. The provider is also known as Miss Nicole Lynn Owen Fnp-Bc.

Q: What is Nicole Moore's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Nicole Moore was last updated on February 9, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since June 03, 2013PECOS Enrolled

4475 SAN JUAN AVE, JACKSONVILLE, FL 32210(615) 425-4258 Get Directions Write a Review

NPPES record last updated: February 9, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Feb 9, 2024, May 9, 2017 (2 updates tracked since 2017).

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About Mrs. Nicole Lynn Moore Crnp NPPES

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

MRS. NICOLE LYNN MOORE CRNP (NPI 1780021436) is an individual family provider in Jacksonville, Florida, licensed in Florida (APRN11009416) and active in the NPI registry since June 2013. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1780021436

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameMRS. NICOLE LYNN MOORECredential: CRNP

Location Address4475 SAN JUAN AVEJacksonville, FL 32210-3357

Mailing Address1512 Turtle Bay CvPonte Vedra Beach, FL 32082-6506 · (720) 707-9033

Phone(615) 425-4258

Sole ProprietorNo

Enumeration DateJune 3, 2013

Last NPPES UpdateFebruary 9, 20242 updates tracked since enumeration

NPPES CertifiedFebruary 9, 2024

✔ NPI 1780021436 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

Licenses✔ Licensed in FL · APRN11009416✔ Licensed in MD · R179324✔ Licensed in CO · 0993089

4475 SAN JUAN AVE, Jacksonville, FL 32210

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Other Names 1

Former Name (1)Miss Nicole Lynn Owen Fnp-bc

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource (Common Ground Healthcare).Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Nicole Lynn Moore Crnp 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

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

Minuteclinic LLC

657 mi

Family

7955 TUCKERMAN LN
Rockville, MD 20854

Reassigned Medicare billing, Florida enrollment
517 clinicians in this Medicare group

NPI 1134191836 (866) 389-2727

Signify Health Medical Associates, PLLC

909 mi

General Practice

4055 VALLEY VIEW LN STE 700
Dallas, TX 75244

Reassigned Medicare billing, Colorado, Georgia, Maryland and Nebraska enrollments
290 clinicians in this Medicare group

NPI 1750845863 (972) 715-3800

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

36 services35 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

34 services34 patients

Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus 87426

An immunoassay test for severe acute respiratory syndrome coronavirus is a diagnostic tool. It uses your body's immune response to detect the presence of the virus. It involves taking a sample, usually from your nose or throat, which is then analyzed in a lab for signs of the virus.

23 services23 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

20 services20 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

18 services18 patients

Urinalysis, manual test 81002

A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.

12 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32210 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

$87.62 typical visit price

range $56.00 – $171.84

Typical copayment $21.90 (range $14.00 – $42.96)

Most-billed visit code 99203

Established Patient

$99.16 typical visit price

range $17.57 – $139.16

Typical copayment $24.79 (range $4.39 – $34.79)

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 13

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

MRS. SHANNON RENEE CHAPPELL APRN

Nurse Practitioner (Family)