Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1730602806 Individual Practitioner Female Practitioner

Dr. Simone Shardae Williams Moore , MD

Pediatrics • Mound Bayou, MS

Professional Overview & Biography Verified Profile Summary

Dr. Simone Moore, MD is a registered healthcare professional specializing in Pediatrics in Mound Bayou, MS. Practice services are available at 702 MARTIN LUTHER KING ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

702 Martin Luther King St

Mound Bayou, MS 387629314

Telephone 6627418800
Fax 6627418925
Associated Practice Facility / Clinic
🏢 Delta Health Center Facility NPI 1104848787

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Mound Bayou, MS

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 19.1 Yrs
Regional Practice Density
2 Specialists

Practicing in Mound Bayou, MS (436 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-08-13
Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License MS 27978

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Student in an Organized Health Care Education/Training Program

NUCC Taxonomy Code: 390200000X

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
04501349 (MS)

Secondary Practice Locations

2500 N State St

Jackson, MS 392164500

Phone: 6019845200

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

8 Associated Practitioners
Daffany Williams , PMHNP-BC

Nurse Practitioner - Psychiatric/Mental Health

NPI 1023990710

Psychiatric-Mental Health Nurse Practitioner (Board Certified)

Anthony Oliveri

Physical Medicine & Rehabilitation

NPI 1043841067
Amee West , PTA

Physical Therapy Assistant

NPI 1104417625

Physical Therapist Assistant

NPI 1285886465

Doctor of Medicine (M.D.)

Marketta Blue

Family Medicine

NPI 1548671514
NPI 1720721178

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

10 Historical Events
📍
Updated Business Mailing Address January 08, 2025

Registered at 702 MARTIN LUTHER KING ST, MOUND BAYOU, MS 387629314 (Tel: 6627418880)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 08, 2025

Student in an Organized Health Care Education/Training Program

📍
Updated Practice Location August 05, 2020

Registered at 702 MARTIN LUTHER KING ST, MOUND BAYOU, MS 387629314 (Tel: 6627418800)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 05, 2020

Pediatrics (License #27978 in MS)

NPI Profile Active July 20, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location July 20, 2017

Registered at 2500 N STATE ST, JACKSON, MS 392164500 (Tel: 6019845200)

📍
Updated Business Mailing Address July 20, 2017

Registered at 2500 N STATE ST, JACKSON, MS 392164500

👤
Provider Name / Credentials Updated July 20, 2017

Recorded as SIMONE MOORE, MD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 20, 2017

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration July 20, 2017

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1730602806
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 20, 2017
Last Update: August 13, 2025
Sole Proprietor: No

Mailing Address

702 Martin Luther King St

Mound Bayou, MS 387629314

Phone: 6627418902

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.