Dr Shannon Monique Moore, PHD - Medicare Psychologist in Jackson, MS

Dr Shannon Monique Moore, PHD is a medicare enrolled "Psychologist - Clinical" provider in Jackson, Mississippi. Her current practice location is 1675 Lakeland Dr Ste 304, Jackson, Mississippi. You can reach out to her office (for appointments etc.) via phone at (769) 524-4578.

Dr Shannon Monique Moore is licensed to practice in Mississippi (license number 55981) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1154636611.

Contact Information

Dr Shannon Monique Moore, PHD
1675 Lakeland Dr Ste 304,
Jackson, MS 39216
(769) 524-4578
(769) 524-4630

Map and Direction




Healthcare Provider's Profile

Full NameDr Shannon Monique Moore
GenderFemale
SpecialityPsychologist - Clinical
Location1675 Lakeland Dr Ste 304, Jackson, Mississippi
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1154636611
  • Provider Enumeration Date: 08/09/2010
  • Last Update Date: 03/22/2019
  Medicare PECOS Information:
  • PECOS PAC ID: 0749570877
  • Enrollment ID: I20160602000746

Medical Identifiers

Medical identifiers for Dr Shannon Monique Moore such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1154636611NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
103TC0700XPsychologist - Clinical 55981 (Mississippi)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Shannon Monique Moore is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Shannon Monique Moore, PHD
Po Box 13563,
Jackson, MS 39236-3563

Ph: (769) 524-4578
Dr Shannon Monique Moore, PHD
1675 Lakeland Dr Ste 304,
Jackson, MS 39216

Ph: (769) 524-4578

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

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Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.