JORDAN RUSSELL MOORE – Psychiatric/Mental Health Nurse Practitioner, NPI 1821651571
Psychiatric/Mental Health Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
14,984 NURSE PRACTITIONER in OH
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Provider Addresses for JORDAN RUSSELL MOORE
206, South Mulberry Street, East Gambier Street Historic District, Mount Vernon, Knox County, Ohio, 43050, United States
MOUNT VERNON, OH 430503331
Phone: (740) 399-3008
Type: Mailing
206 S MULBERRY ST STE A
MOUNT VERNON, OH 430503331
Phone: (740) 326-9988
Fax: (740) 326-1175
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 99 Open Payments records for all available years, with a total value of $1,828.
Total Amount is formed as General ($1,828) + Research ($0) + Ownership ($0) = $1,828.
Last reported payment date: 2024-12-10 • Largest payer in this snapshot: ABBVIE INC. ($549).
Total Amount
$1,828
General + Research + Ownership
Payments
99
Total payment records
General Amount
$1,828
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
| Company | Amount |
|---|---|
| ABBVIE INC. | $549 |
| Abbott Laboratories | $346 |
| Novo Nordisk Inc | $205 |
| AstraZeneca Pharmaceuticals LP | $131 |
| PFIZER INC. | $88 |
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: 2019-09-13
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20190913002137 | I | Nurse Practitioner | OH | TBD |
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.
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 43050)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | OH | |
| Nurse Practitioner | OH | |
| Nurse Practitioner | OH | |
| - | OH | |
| Cardiovascular Disease (Cardiology), Cardiac Electrophysiology, Internal Medicine | OH | |
| E N D O C R I N O L O G Y | OH | |
| Cardiovascular Disease (Cardiology), Internal Medicine | OH | |
| Emergency Medicine | OH | |
| - | OH | |
| Internal Medicine | OH |
Reviews
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