MRS. ANNIE RUTH MOORE (APRN) – Psychiatric/Mental Health Nurse Practitioner, NPI 1114562048

MRS. ANNIE RUTH MOORE (APRN) is a healthcare provider. based in Wichita falls, Texas. specializing in NURSE PRACTITIONER. They hold the professional credentials APRN. They hold a License No. AP139536 (TX). The NPI Number for MRS. ANNIE RUTH MOORE (APRN) is 1114562048

Main info

Female
8 Years Of Experience
Accepts Medicare Assignment
Name
MRS. ANNIE RUTH MOORE (APRN)
NPI
1114562048
Phone
Not provided
Address
900 7TH ST
Enumeration Date
14 November 2019
Last Update Date
17 December 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9407663320
Graduation Year
2018 (8 years ago)
PAC ID
6608302625
Group Practice PAC ID
2163417478
Professional Enrollment ID
I20241212004418
Address ID
TX763014300WI1600XSTXX300

Contacts

Secure Messaging
amoore14334@unitedregional.medalliesdirect.net
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness85
Years active:6State licenses:1Other namesUpdated within 12 months

22,204 NURSE PRACTITIONER in TX

Provider Addresses for MRS. ANNIE RUTH MOORE (APRN)

  • 900 7TH ST

    WICHITA FALLS, TX 763012402

    Phone:

    Type: Mailing

  • 1600 11TH ST

    WICHITA FALLS, TX 763014300

    Phone: (940) 764-8725

    Fax: (940) 764-8179

    Type: Location

  • PO BOX 9261

    WICHITA FALLS, TX 763089261

    Phone: (940) 764-7230

    Fax: (940) 764-7255

    Type: Mailing

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: 2024-12-12

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
I20241212004418INurse PractitionerTXTBD

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 76301)

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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: 2163417478View full group profile
NameSpecialtyState
Physician AssistantTX
-TX
Sports Medicine, Family PracticeTX
Cardiovascular Disease (Cardiology)TX
Internal MedicineTX
U R O L O G YTX
Endocrinology, Internal MedicineTX
Orthopedic SurgeryTX
Physician AssistantTX
Nurse PractitionerTX

Reviews

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Frequently asked questions

Can I use this page to confirm MRS. ANNIE RUTH MOORE (APRN)'s NPI?
Yes. MRS. ANNIE RUTH MOORE (APRN) is listed with NPI 1114562048 in the public NPI dataset.
Does the file indicate MRS. ANNIE RUTH MOORE (APRN) is practicing under active NPI?
Directory data currently reports MRS. ANNIE RUTH MOORE (APRN) as active.
What taxonomy line describes MRS. ANNIE RUTH MOORE (APRN)?
For research purposes, treat MRS. ANNIE RUTH MOORE (APRN) as Psychiatric/Mental Health Nurse Practitioner in this dataset. Clinical services aligned with this taxonomy classification.
Where is MRS. ANNIE RUTH MOORE (APRN) based?
MRS. ANNIE RUTH MOORE (APRN) is tied to Wichita Falls, Texas in the data we show; additional addresses may exist on the full record.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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