Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

John R Moore, APRNCNP

Individual provider Addiction Medicine (Psychiatry & Neurology) Physician · NPI 1720794167

John R Moore, APRNCNP is a Nurse Practitioner in Monroe, Michigan. Graduated from Medical College of Ohio in 2022, 4 years ago. Practices with Promedica Monroe Physicians, a 64-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Ohio.

Years since qualifying
4
Trained at
Medical College of Ohio
Licensed in
OH
In the registry since
2023
Specialties on file
2

Practice location Address checks out

718 N Macomb St
Monroe, MI 48162-7815
Phone: (419) 708-8228
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatry Physician (primary) Taxonomy 2084P0800X · Licence 0032642 (OH)
Addiction Medicine (Psychiatry & Neurology) Physician Taxonomy 2084A0401X · Licence 0032642 (OH)

Record details

NPI number1720794167
Entity typeIndividual (Type 1)
GenderMale
Credentials APRNCNP
Sole proprietorNo
NPI enumeratedJanuary 30, 2023
Last updated in NPPESJanuary 30, 2023
Certification dateJanuary 29, 2023
Mailing address7012 Cloister Rd, Toledo, OH 43617-2208

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolMEDICAL COLLEGE OF OHIO
Graduated 2022 (4 years in practice)
Group practice Promedica Monroe Physicians — 64 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Monroe