DOMINIQUE MOORE (NP) – Psychiatric/Mental Health Nurse Practitioner, NPI 1063294205

DOMINIQUE MOORE (NP) is a healthcare provider. based in Ashland, Virginia. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. 0024188517 (VA). The NPI Number for DOMINIQUE MOORE (NP) is 1063294205

Main info

Female
Sole Proprietor
3 Years Of Experience
Accepts Medicare Assignment
Name
DOMINIQUE MOORE (NP)
NPI
1063294205
Phone
(804) 897-9355
Address
12300 WASHINGTON HWY
Enumeration Date
20 October 2023
Deactivation Date
10 December 2025
Reactivation Date
17 December 2025
Last Update Date
12 January 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8043654222
Graduation Year
2023 (3 years ago)
PAC ID
9436593571
Group Practice PAC ID
8527968742
Professional Enrollment ID
I20240216003145
Address ID
VA230057646AS12300HWYX300
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness85
Years active:2State licenses:1Digital endpointsOther names

8,303 NURSE PRACTITIONER in VA

Provider Addresses for DOMINIQUE MOORE (NP)

  • 12300 WASHINGTON HWY

    ASHLAND, VA 230057646

    Phone: (804) 897-9355

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

Open Payments (CMS)

CMS reports 76 Open Payments records for all available years, with a total value of $1,397.

Total Amount is formed as General ($1,397) + Research ($0) + Ownership ($0) = $1,397.

Last reported payment date: 2024-12-10 • Largest payer in this snapshot: ITI, Inc. (d/b/a Intra-Cellular Therapies, Inc.) ($276).

Total Amount

$1,397

General + Research + Ownership

Payments

76

Total payment records

General Amount

$1,397

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

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: 2024-02-16

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
I20240216003145INurse PractitionerVATBD

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 23005)

Loading plans...

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: 8527968742View full group profile
NameSpecialtyState
Mental Health CounselorVA
Mental Health CounselorVA
Mental Health CounselorVA
Nurse PractitionerVA
Clinical Social WorkerVA
Clinical Social WorkerVA
Mental Health CounselorVA
Mental Health CounselorVA
Clinical Social WorkerVA
Clinical Social WorkerVA

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

What is the standard ID for DOMINIQUE MOORE (NP) in the U.S.?
In the U.S., DOMINIQUE MOORE (NP) is identified by NPI 1063294205.
Quick check: is DOMINIQUE MOORE (NP) active?
Public NPPES data shows DOMINIQUE MOORE (NP) with an active NPI status right now.
Which specialty label fits DOMINIQUE MOORE (NP)?
NPPES ties DOMINIQUE MOORE (NP) to Psychiatric/Mental Health Nurse Practitioner in the taxonomy section. Clinical services aligned with this taxonomy classification.
What city is tied to DOMINIQUE MOORE (NP)?
The directory associates DOMINIQUE MOORE (NP) with Ashland, Virginia. Check all listed addresses for suites or satellite offices.
Can I export DOMINIQUE MOORE (NP)'s record?
You can download the official NPPES record; we summarize key fields for readability.

Similar Providers

MRS. ELLEN ELAINE TINSLEY (NP)

Psychiatric/Mental Health Nurse Practitioner
195 N ESKEW LN
NPI: 1578833828

JESSICA R GEEN (N.P.)

Psychiatric/Mental Health Nurse Practitioner
5483 MOORETOWN RD
NPI: 1295081917

DAERYL WILLIAMSON (PMHNP)

Psychiatric/Mental Health Nurse Practitioner
107, South 5th Street, Monroe Ward, Richmond, Richmond City, Virginia, 23219, United States
NPI: 1295397123

RY WILLIS BERGUM (PMHNP)

Psychiatric/Mental Health Nurse Practitioner
12300 WASHINGTON HWY
NPI: 1275103459
120 W COMMERCE ST
NPI: 1164196523

MS. SINDHU KODOTH

Psychiatric/Mental Health Nurse Practitioner
10845 PROVIDENCE WOODS LN
NPI: 1235919523

Coastal Psychiatry and Wellness

Psychiatric/Mental Health Nurse Practitioner
10469 ATLEE STATION RD STE 100
NPI: 1740089416