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

Mr. Justin Claude Moore, NURSEPRACTITIONER

Individual provider Acute Care Nurse Practitioner · NPI 1164180535

Mr. Justin Claude Moore, NURSEPRACTITIONER is a Nurse Practitioner in Greenville, South Carolina. Qualified in 2021, 5 years ago. Practices with Prisma Health University Medical Group, a 2,446-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in South Carolina.

Years since qualifying
5
Licensed in
SC
In the registry since
2021
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Practice location Address checks out

701 Grove Rd Fl 5
Greenville, SC 29605-4210
Phone: (864) 455-4411
Fax: (864) 455-4480
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3 Saint Francis Dr Ste 360, Greenville, SC 29601-3972 — (864) 233-4349

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence 25609 (SC)

Record details

NPI number1164180535
Entity typeIndividual (Type 1)
GenderMale
Credentials NURSEPRACTITIONER
Sole proprietorYes
NPI enumeratedDecember 2, 2021
Last updated in NPPESDecember 2, 2024
Certification dateDecember 2, 2024

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Prisma Health University Medical Group — 2446 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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