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

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: August 02, 2026.

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

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
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

Other Names 1

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

Medicare Participation & PECOS CMS

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

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.

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.

Nurse Practitioner (Family)
4475 SAN JUAN AVE
JACKSONVILLE, FL 32210
Nurse Practitioner (Family)
4475 SAN JUAN AVE
JACKSONVILLE, FL 32210
Pharmacist
4475 SAN JUAN AVE
JACKSONVILLE, FL 32210
Pharmacy
4475 SAN JUAN AVE
JACKSONVILLE, FL 32210
Nurse Practitioner (Family)
4475 SAN JUAN AVE
JACKSONVILLE, FL 32210
Pharmacist
4475 SAN JUAN AVE
JACKSONVILLE, FL 32210
Nurse Practitioner (Family)
4475 SAN JUAN AVE
JACKSONVILLE, FL 32210
Pharmacist
4475 SAN JUAN AVE
JACKSONVILLE, FL 32210

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 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.

Where is Nicole Moore located?

Nicole Moore practices at 4475 San Juan Ave, Jacksonville, FL 32210. The listed phone number is (615) 425-4258.

What is Nicole Moore's specialty?

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

Is Nicole Moore enrolled in Medicare?

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

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.