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

Mrs. Charlene K Moore, PA-C

Individual provider Physician Assistant · NPI 1639325376

Mrs. Charlene K Moore, PA-C is a Physician Assistant in Port St Lucie, Florida. Qualified in 2009, 17 years ago. Accepts Medicare assignment. Licensed in Florida and Ohio.

Years since qualifying
17
Licensed in
FL, OH
In the registry since
2008
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

160 NW Central Park Plz Ste 103
Port St Lucie, FL 34986-1825
Phone: (772) 212-7636
Fax: (772) 212-7625
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA9107673 (FL)
Physician Assistant Taxonomy 363A00000X · Licence 50002517 (OH)

Record details

NPI number1639325376
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedAugust 13, 2008
Last updated in NPPESDecember 23, 2022
Certification dateDecember 23, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Port St Lucie