Sydney Moore
Nurse Practitioner in Atlanta, GA. Individual provider (NPI-1).
NPI number1336836626
StatusActive
Last updated in NPPESAug 31, 2026
Details
- NPI
- 1336836626
- Entity type
- Individual (NPI-1)
- Name
- Sydney Moore
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Apr 18, 2023
- Certification date
- Aug 31, 2026
- Last updated
- Aug 31, 2026
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - NURSE PRACTITIONER
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | RN307106 | GA | Yes |
Practice location
211 Perimeter Center Pkwy Ne Ste 200Atlanta, GA 30346-1305
Phone 855-492-7642
Mailing address
2020 Pendleton PlSuwanee, GA 30024-2766
Phone 404-625-0913
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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