JACOB W MOORE JR. (NPI# 1023165610) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023165610 |
| Entity Type | Individual |
| Full Name | JACOB W MOORE JR. |
| Credential | NP |
| Practice Address |
550 S Beretania St Ste 601 Honolulu HI 96813-2423 |
| Practice Telephone | (808) 691-8877 |
| Practice Fax Number | 8086918875 |
| Mailing Telephone | (808) 691-8877 |
| Mailing Fax Number | 8086918875 |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2017-06-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
APRN-558 | HI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| HI | HMSA BILLING NUMBER | 0000245274 | 01 |
| HI | 55115201 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154617058 | Jacob E Moore | Emergency Medicine | 2326 N Lincoln Park W Apt 4b, Chicago, IL 60614-3446 | 2011-06-20 |
| 1043459175 | Jacob B Moore | Physical Medicine & Rehabilitation | 2707 Stange Road Suite 102, Mcfarland Clinic PC, Ames, IA 50010-3014 | 2009-02-12 |
| 1144249277 | Jacob Jackson Moore | Ophthalmology | 900 Morgan Ave, Corpus Christi, TX 78404-2028 | 2006-07-19 |
| 1831719947 | Jacob Ryan Moore | Student in an Organized Health Care Education/Training Program | 2100 Stantonsburg Rd, Greenville, NC 27834-2818 | 2020-04-17 |
| 1497384424 | Jacob Aaron Moore | Nurse Practitioner | 800 Rose St, Lexington, KY 40536-7001 | 2020-04-02 |
| 1255892287 | Jacob James Moore | Psychiatry & Neurology | 155 N Fresno St, Fresno, CA 93701-2302 | 2019-03-31 |
| 1336644723 | Jacob Clark Moore | Student in an Organized Health Care Education/Training Program | 250 Park St, Bowling Green, KY 42101-1760 | 2018-03-27 |
| 1821512179 | Jacob Moore | Specialist/Technologist | 116 Ward Sports Medicine Building, Greenville, NC 27858 | 2017-07-28 |
| 1588027007 | Jacob Moore | Pharmacist | 1745 Quentin Rd, Lebanon, PA 17042-7435 | 2016-04-01 |
| 1750762928 | Jacob Robert Moore | Emergency Medicine | 5841 S Maryland Ave Rm L539, Chicago, IL 60637-1447 | 2015-06-14 |
| Street Address |
550 S BERETANIA ST STE 601 |
| City | HONOLULU |
| State | HI |
| Zip Code | 96813-2423 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093790503 | Mark T Herrington | Nurse Practitioner | 550 S Beretania St Ste 601, Honolulu, HI 96813-2423 | 2005-12-08 |
| 1942777388 | Kaitlyn Leary | Nurse Practitioner | 550 S Beretania St Ste 601, Honolulu, HI 96813-2423 | 2018-10-24 |
| 1083108039 | Paula Marie Paulsen | Nurse Practitioner | 550 S Beretania St Ste 601, Honolulu, HI 96813-2423 | 2018-06-21 |
| 1114457454 | Lianne Sadako Higa | Clinical Nurse Specialist | 550 S Beretania St Ste 601, Honolulu, HI 96813-2423 | 2017-06-19 |
| 1164974127 | Kailie Wong | Nurse Practitioner | 550 S Beretania St Ste 601, Honolulu, HI 96813-2423 | 2016-10-25 |
| 1205290756 | Marina Hitosugi-levesque | Internal Medicine | 550 S Beretania St Ste 601, Honolulu, HI 96813-2423 | 2016-04-11 |
| 1134590508 | Amanda M L Wong | Nurse Practitioner | 550 S Beretania St Ste 601, Honolulu, HI 96813-2423 | 2015-10-12 |
| 1689053308 | Lyndsey Rei Okamoto | Nurse Practitioner | 550 S Beretania St Ste 601, Honolulu, HI 96813-2423 | 2015-05-27 |
| 1275943755 | Monica Yan Nei Cheung Katz | Family Medicine | 550 S Beretania St Ste 601, Honolulu, HI 96813-2423 | 2014-05-06 |
| 1699193391 | Alan Kuo | Internal Medicine | 550 S Beretania St Ste 601, Honolulu, HI 96813-2423 | 2014-04-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952902322 | Kawehi Hanohano-navarro | Behavior Technician | Attn: Behavioral Health Works 500 Ala Moana Blvd. Suit, Honolulu, HI 96813 | 2020-11-03 |
| 1659971489 | University Clinical Education & Research Associates | Clinical Medical Laboratory | 651 Ilalo Street, Bioscience Bldg Rm 333, Honolulu, HI 96813 | 2020-10-30 |
| 1700490919 | Tiana Taylor Williams | Behavior Technician | 7 Waterfront Plaza, 500 Ala Moana Blvd, Suite 400, Honolulu, HI 96813 | 2020-09-04 |
| 1134761109 | Florence Kwitonda | Behavior Technician | 500 Ala Moana Blvd., Suite 400, Honolulu, HI 96813 | 2019-10-11 |
| 1629629373 | Alyssa Niel Gethings | Behavior Technician | Attn: Behavioral Health Works 500 Ala Moana Blvd. Suite, Honolulu, HI 96813 | 2019-09-24 |
| 1851949069 | Miho Camarata | Behavior Technician | Attn: Behavioral Health Works 500 Ala Moana Blvd, Suite 400, Honolulu, HI 96813 | 2019-08-30 |
| 1326696519 | Chanelle Ashley Ramos | Behavior Technician | Attn: Behavioral Health Works 500 Ala Moana Blvd., Suite 400, Honolulu, HI 96813 | 2019-08-30 |
| 1568022580 | Fataly Willy | Behavioral Analyst | 500 Alamoana Blvd #7-400, Honolulu, HI 96813 | 2019-06-20 |
| 1538624069 | Galaxy Urgent Care Inc | Internal Medicine | 50 South Beretania St, C210 B, Honolulu, HI 96813 | 2019-02-08 |
| 1376010124 | Queen's Development Corporation and Subsidiaries | Clinic/Center | 400 Keawe Street, Suite 100, Honolulu, HI 96813 | 2018-10-30 |
| Find all providers in zip 96813 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578000899 | Katrina Lu | Nurse Practitioner | 521 Ala Moana Blvd, Honolulu, HI 96813-4913 | 2017-01-24 |
| 1912373705 | Laura Reichhardt | Nurse Practitioner | 3166 Alika Ave, Honolulu, HI 96817-1103 | 2015-08-14 |
| 1134473366 | Carl T Pitre | Nurse Practitioner | 1329 Lusitana St Ste 609, Honolulu, HI 96813-2431 | 2012-11-09 |
| 1487985966 | Angela K Goodbody | Nurse Practitioner | 3124 Numana Rd, Honolulu, HI 96819-2908 | 2010-01-22 |
| 1508199365 | Justin Eric Henderson | Nurse Practitioner | 619 Kapahulu Ave, Ph, Honolulu, HI 96815-3853 | 2009-09-11 |
| 1043427552 | Julie Graham | Nurse Practitioner | 547 12th Ave, Honolulu, HI 96816-2244 | 2007-05-16 |
| 1851480701 | Christella Guzman | Nurse Practitioner | 932 Ward Ave Fl 6, Honolulu, HI 96814-2131 | 2006-10-11 |
| 1083108039 | Paula Marie Paulsen | Nurse Practitioner | 550 S Beretania St Ste 601, Honolulu, HI 96813-2423 | 2018-06-21 |
| 1831690858 | Lindsay Taguma | Nurse Practitioner | 2230 Liliha St, Honolulu, HI 96817-1646 | 2018-02-25 |
| 1356853527 | Christina Marie Beyers Wang | Nurse Practitioner | 677 Ala Moana Blvd Ste 226, Honolulu, HI 96813-5416 | 2017-10-27 |
| Find all providers in HONOLULU | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.