Shannon Moore, PHD
NPI 1154636611 · Clinical Psychologist · Jackson, MS
Enrolled with Medicare as Order and Referring Only - Clinical Psychologist · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Shannon Moore, PHD is a Clinical Psychologist provider in Jackson, MS (NPI 1154636611).
Provider details
- NPI number
- 1154636611
- Entity type
- Individual
- Primary specialty
- Clinical PsychologistBehavioral Health & Social Service Providers
- Credential
- PHD
- Sex
- Female
- Sole proprietor
- Yes
- License
- 55981 (MS)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
16 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (1)
- 1818 Albion St Ste 114Nashville, TN 37208-2918Phone: (615) 327-4751
Registry dates
- Enumerated
- 2010-08-09
- Last updated
- 2019-03-22
Frequently asked questions
- What is Shannon Moore's NPI number?
- Shannon Moore's National Provider Identifier (NPI) is 1154636611, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Shannon Moore's specialty?
- Shannon Moore is listed in the NPPES registry with a primary specialty of Clinical Psychologist (Behavioral Health & Social Service Providers).
- Where is Shannon Moore located?
- Shannon Moore's practice location on file with NPPES is 1675 Lakeland Dr Ste 304, Jackson, MS 39216.
- What is Shannon Moore's phone number?
- The practice phone number listed in the NPPES registry for Shannon Moore is (769) 524-4578.
- Does Shannon Moore accept Medicare?
- Shannon Moore is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Shannon Moore's NPI active?
- Yes — Shannon Moore's NPI (1154636611) is active in the NPPES registry as of the last update on 2019-03-22.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.