Jessica Porter Moore, PA
Physician Assistant in Concord, NC. Individual provider (NPI-1).
NPI number1972561439
StatusActive
Last updated in NPPESJul 15, 2024
Details
- NPI
- 1972561439
- Entity type
- Individual (NPI-1)
- Name
- Jessica Porter Moore
- Credential
- PA
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 3, 2006
- Last updated
- Jul 15, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PHYSICIAN ASSISTANT
- 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 |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 103356 | NC | Yes |
Practice location
920 Church St NSuite 255
Concord, NC 28025-2927
Phone 704-403-1331
Mailing address
Po Box 19305Charlotte, NC 28219-9305
Other practice locations
1000 Blythe Blvd
Charlotte, NC 28203-5812
Charlotte, NC 28203-5812
Phone 704-355-0720
2001 Vail Ave
Charlotte, NC 28207-1248
Charlotte, NC 28207-1248
Phone 704-304-6070
10628 Park Rd
Charlotte, NC 28210-8407
Charlotte, NC 28210-8407
Phone 704-667-7070
8800 N Tryon St
Charlotte, NC 28262-3300
Charlotte, NC 28262-3300
Phone 704-863-6241
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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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All 161 Physician Assistant providers in Concord · All 4,546 providers in Concord
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