JENNIFER MOORE (AGACNP-BC, DNP) – Nurse Practitioner, NPI 1962086165

JENNIFER MOORE (AGACNP-BC, DNP) is a healthcare provider. based in South jordan, Utah. specializing in NURSE PRACTITIONER. They hold the professional credentials AGACNP-BC, DNP. They hold a License No. 7014826-4405 (UT). The NPI Number for JENNIFER MOORE (AGACNP-BC, DNP) is 1962086165

Main info

Female
Sole Proprietor
5 Years Of Experience
Accepts Medicare Assignment
Name
JENNIFER MOORE (AGACNP-BC, DNP)
NPI
1962086165
Phone
(801) 362-4227
Address
5089 W DUCKHORN DR
Enumeration Date
12 May 2021
Last Update Date
15 October 2025

Doctor Profile

Medical School Name
UNIVERSITY OF UTAH SCHOOL OF MEDICINE
Secondary Phone
8017970097
Graduation Year
2021 (5 years ago)
PAC ID
0345643946
Group Practice PAC ID
5496129017
Professional Enrollment ID
I20210720001991
Address ID
UT840576301OR700XX800X336
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience39
Completeness85
Years active:5State licenses:1Digital endpointsOther names

2,655 NURSE PRACTITIONER in UT

Provider Addresses for JENNIFER MOORE (AGACNP-BC, DNP)

  • 5089 W DUCKHORN DR

    SOUTH JORDAN, UT 840098145

    Phone: (801) 362-4227

    Type: Mailing

  • 157 N 400 W Ste B7

    Orem, UT 840571909

    Phone: (801) 797-0097

    Fax: (877) 690-5163

    Type: Location

  • 1865 N 760 W

    OREM, UT 840572011

    Phone: (801) 362-4227

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 7 Open Payments records for all available years, with a total value of $218.

Total Amount is formed as General ($218) + Research ($0) + Ownership ($0) = $218.

Last reported payment date: 2024-11-18 • Largest payer in this snapshot: IDORSIA PHARMACEUTICALS US INC ($99).

Total Amount

$218

General + Research + Ownership

Payments

7

Total payment records

General Amount

$218

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-18

Latest reported date

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: 2021-07-20

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
I20210720001991INurse PractitionerUTTBD

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
99308Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes749207$0
99304Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes203196$0
99309Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes12070$0
99348Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes8111$0
99307Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes4237$0
View full utilization report →

Insurance plans in this area (ZIP 84009)

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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: 5496129017View full group profile
NameSpecialtyState
Nurse PractitionerUT
Nurse PractitionerUT
P O D I A T R YUT

Reviews

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Frequently asked questions

What identifier follows JENNIFER MOORE (AGACNP-BC, DNP) across health systems?
The NPI 1962086165 uniquely identifies JENNIFER MOORE (AGACNP-BC, DNP) in U.S. healthcare data.
Quick check: is JENNIFER MOORE (AGACNP-BC, DNP) active?
Public NPPES data shows JENNIFER MOORE (AGACNP-BC, DNP) with an active NPI status right now.
Which specialty label fits JENNIFER MOORE (AGACNP-BC, DNP)?
NPPES ties JENNIFER MOORE (AGACNP-BC, DNP) to Nurse Practitioner in the taxonomy section. Clinical services aligned with this taxonomy classification.
Is JENNIFER MOORE (AGACNP-BC, DNP) tied to South Jordan, Utah?
If you are local to South Jordan, Utah, JENNIFER MOORE (AGACNP-BC, DNP) may be relevant to your search.
Can I export JENNIFER MOORE (AGACNP-BC, DNP)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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