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

Mr. Mark Moore, CFNP

Individual provider Nurse Practitioner · NPI 1962489567

Mr. Mark Moore, CFNP is a Nurse Practitioner in Meridian, Mississippi. Qualified in 1997, 29 years ago. Practices with Cardiovascular Institute of the South, LLC, a 144-clinician group and accepts Medicare assignment. Licensed in Mississippi.

Years since qualifying
29
Licensed in
MS
In the registry since
2005
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Practice location Address checks out

1600 22nd Ave Medical Towers Iii
Meridian, MS 39301-3223
Phone: (601) 483-5322
Fax: (601) 581-2289
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence R669059 (MS)

Record details

NPI number1962489567
Entity typeIndividual (Type 1)
GenderMale
Credentials CFNP
Sole proprietorNo
NPI enumeratedDecember 27, 2005
Last updated in NPPESJune 2, 2011
Mailing address1600 22nd Ave, Medical Towers Iii, Meridian, MS 39301-3223

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 1997 (29 years in practice)
Group practice Cardiovascular Institute Of The South, Llc — 144 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Meridian