REBECCA SUE MOORE (FNP) – Family Nurse Practitioner, NPI 1750890042

REBECCA SUE MOORE (FNP) is a healthcare provider. based in Grand rapids, Michigan. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP. They hold a License No. 4704336548 (MI). The NPI Number for REBECCA SUE MOORE (FNP) is 1750890042

Main info

Female
9 Years Of Experience
Accepts Medicare Assignment
Name
REBECCA SUE MOORE (FNP)
NPI
1750890042
Phone
Not provided
Address
100 MICHIGAN ST NE # MC845
Enumeration Date
29 September 2017
Last Update Date
4 August 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9894663332
Graduation Year
2017 (9 years ago)
PAC ID
2264790708
Group Practice PAC ID
3375451404
Professional Enrollment ID
I20171211001889
Address ID
MI488011013AL321XXDRXX401

Contacts

FHIR Endpoint
https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/
Secure Messaging
rmoore245886@epic00.shdirect.org
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience40
Completeness85
Years active:8State licenses:1Other namesUpdated within 12 months

8,106 NURSE PRACTITIONER in MI

Provider Addresses for REBECCA SUE MOORE (FNP)

  • 100 MICHIGAN ST NE # MC845

    GRAND RAPIDS, MI 495032560

    Phone:

    Type: Mailing

  • 300 N PATTERSON RD

    REED CITY, MI 496778041

    Phone: (231) 832-7170

    Type: Location

  • 300 N Patterson Rd

    Reed City, MI 496778041

    Phone: (231) 832-7170

    Type: Location

  • 4000 WELLNESS DR

    MIDLAND, MI 486702000

    Phone:

    Type: Mailing

  • 321 E WARWICK DR

    ALMA, MI 488011013

    Phone: (989) 466-3332

    Fax: (989) 466-6805

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2019-04-24

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
I20190424000170INurse PractitionerMITBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 49503)

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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: 3375451404View full group profile
NameSpecialtyState
Physician AssistantMI
Physician AssistantMI
Physician AssistantMI
Orthopedic SurgeryMI
Internal MedicineMI
Physician AssistantMI
Medical Oncology, Internal Medicine, Hematology/OncologyMI
-NC
-MI
Family PracticeMI

Reviews

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Frequently asked questions

Does REBECCA SUE MOORE (FNP) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — REBECCA SUE MOORE (FNP) uses 1750890042.
Can I rely on REBECCA SUE MOORE (FNP) being an active provider?
As of the registry snapshot, REBECCA SUE MOORE (FNP) is marked active.
What healthcare role does REBECCA SUE MOORE (FNP) hold?
Scheduling teams often label REBECCA SUE MOORE (FNP) under Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What area does REBECCA SUE MOORE (FNP) serve?
REBECCA SUE MOORE (FNP)'s listing highlights Grand Rapids, Michigan; more addresses can appear in NPPES.
How many locations tie to this NPI?
5 practice locations appear in the available data.

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