JODI-ANN CAMILLE MOORE (P.A.) – Physician Assistant, NPI 1962658963

JODI-ANN CAMILLE MOORE (P.A.) is a healthcare provider. based in Cartersville, Georgia. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials P.A.. They hold a License No. 005365 (GA). The NPI Number for JODI-ANN CAMILLE MOORE (P.A.) is 1962658963

Main info

Female
18 Years Of Experience
Accepts Medicare Assignment
Name
JODI-ANN CAMILLE MOORE (P.A.)
NPI
1962658963
Phone
(470) 227-1600
Address
9 MEDICAL DR NE STE E
Enumeration Date
11 August 2008
Last Update Date
27 May 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6787023376
Graduation Year
2008 (18 years ago)
PAC ID
5597832832
Group Practice PAC ID
1658680764
Professional Enrollment ID
I20080929000156
Address ID
GA301357542DO4645XDRXX401

Contacts

Secure Messaging
jychung@directaddress.net
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience68
Completeness85
Years active:17State licenses:1Other namesUpdated within 12 months

4,430 PHYSICIAN ASSISTANT in GA

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Provider Addresses for JODI-ANN CAMILLE MOORE (P.A.)

  • 9 MEDICAL DR NE STE E

    CARTERSVILLE, GA 301218003

    Phone: (470) 227-1600

    Fax: (470) 227-1606

    Type: Mailing

  • 900, Mohawk Street, Savannah, Chatham County, Georgia, 31419, United States

    STE E.

    SAVANNAH, GA 31419

    Phone: (912) 925-0067

    Fax: (912) 925-2381

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 182 Open Payments records for all available years, with a total value of $3,580.

Total Amount is formed as General ($3,580) + Research ($0) + Ownership ($0) = $3,580.

Last reported payment date: 2024-12-10 • Largest payer in this snapshot: ABBVIE INC. ($582).

Total Amount

$3,580

General + Research + Ownership

Payments

182

Total payment records

General Amount

$3,580

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-10

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2008-09-29

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20080929000156IPhysician AssistantGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
17003Destruction of precancer skin growth, 2-14 growths33558$0
99212Established patient office or other outpatient visit, 10-19 minutes138104$0
17000Destruction of precancer skin growth, 1 growth11980$0
99213Established patient office or other outpatient visit, 20-29 minutes11389$0
11102Biopsy of related skin growth, first growth10591$0
View full utilization report →

Insurance plans in this area (ZIP 30121)

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Provider's Procedures

JODI-ANN CAMILLE MOORE (P.A.) performs procedures in PHYSICIAN ASSISTANT. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICIAN ASSISTANTGA11101Biopsy of each additional growth of skin and/or tissue10057
PHYSICIAN ASSISTANTGA17003Destruction of 2-14 skin growths62975

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1658680764View full group profile
NameSpecialtyState
Dermatology, Micrographic Dermatologic Surgery (Mds)FL
Physician AssistantGA
D E R M A T O L O G YGA
-AL
Nurse PractitionerGA
-GA
Physician AssistantGA
Pathology, DermatologyGA
Nurse PractitionerTN
D E R M A T O L O G YGA

Reviews

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Frequently asked questions

Does JODI-ANN CAMILLE MOORE (P.A.) have a public NPI I can cite?
Public records show JODI-ANN CAMILLE MOORE (P.A.) under NPI 1962658963.
Quick check: is JODI-ANN CAMILLE MOORE (P.A.) active?
Public NPPES data shows JODI-ANN CAMILLE MOORE (P.A.) with an active NPI status right now.
Which specialty label fits JODI-ANN CAMILLE MOORE (P.A.)?
NPPES ties JODI-ANN CAMILLE MOORE (P.A.) to Physician Assistant in the taxonomy section. Clinical services aligned with this taxonomy classification.
Is JODI-ANN CAMILLE MOORE (P.A.) tied to Cartersville, Georgia?
If you are local to Cartersville, Georgia, JODI-ANN CAMILLE MOORE (P.A.) may be relevant to your search.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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