JORDAN DAVID MOORE (NPI# 1134767312) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134767312 |
| Entity Type | Individual |
| Full Name | JORDAN DAVID MOORE |
| Credential | MS, ATC, LAT, CSCS |
| Practice Address |
Boston Sports Institute 900 Worcester St Wellesley MA 02482 |
| Practice Telephone | 7814895088 |
| Mailing Telephone | 7814895088 |
| Enumeration Date | 2019-12-18 |
| Last Update Date | 2019-12-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
3006 | MA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356952337 | Jordan Dru Moore | Speech-Language Pathologist | 2709 Francisco St Unit B, Austin, TX 78702-3920 | 2020-08-12 |
| 1295387660 | Jordan William Moore | Chiropractor | 7921 Tanner Williams Rd Ste B, Mobile, AL 36608-8303 | 2019-07-15 |
| 1164980801 | Jordan Moore | Student in an Organized Health Care Education/Training Program | 800 Galloway Drive, Hammond, LA 70402-0001 | 2019-03-12 |
| 1255826111 | Jordan Moore | Speech-Language Pathologist | 4701 Patrick Henry Dr., Bldg 23, Suite D, Santa Clara, CA 95054 | 2018-06-24 |
| 1124522834 | Jordan Alexander Moore | Technician, Pathology | 4032 Knollbrook Dr Nw, Huntsville, AL 35810-1832 | 2018-03-19 |
| 1134673577 | Jordan Robert Moore | Pharmacist | 202 Becker St, Danville, PA 17821-1180 | 2016-08-14 |
| 1013992619 | Jordan A Moore | Dermatology | 121 E Silver Spring Dr, Whitefish Bay, WI 53217-4702 | 2005-12-07 |
| 1609425743 | Jordan Moore | Behavior Technician | 418b W Mountain St, Kernersville, NC 27284-2534 | 2019-09-11 |
| 1215583091 | Jordan Moore | Case Manager/Care Coordinator | 3111 S 70th St, Fort Smith, AR 72903-5017 | 2019-08-16 |
| 1821651571 | Jordan Russell Moore | Nurse Practitioner | 206 S Mulberry St, Mount Vernon, OH 43050-3331 | 2019-04-18 |
| Street Address |
BOSTON SPORTS INSTITUTE 900 WORCESTER ST |
| City | WELLESLEY |
| State | MA |
| Zip Code | 02482 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245830454 | Hope F. Schroy | Social Worker | 52 Cottage St, Wellesley, MA 02482 | 2020-10-27 |
| 1417586090 | Caroline Otoole | Pharmacist | 10 Thomas Rd, Wellesley, MA 02482 | 2020-04-06 |
| 1386198422 | Bradford Richard Mattison | Dentist | 1 Hollis St Ste 340, Wellesley, MA 02482 | 2016-08-05 |
| 1245614957 | Alexandra Alexandra Rogers | Nurse Practitioner | 984 Worcester Street, Wellesley, MA 02482 | 2015-07-13 |
| 1467628347 | Marilyn D Feldman | Marriage & Family Therapist | 11 Turner Rd, Wellesley, MA 02482 | 2008-05-01 |
| 1093861668 | Joel Morris Prives | Dentist | 316 Weston Rd, Wellesley, MA 02482 | 2007-01-26 |
| 1679630826 | Richard H Stellar | Psychologist | 486 Washington Street, Wellesley, MA 02482 | 2007-01-03 |
| 1669540407 | Jane K Martin | Acupuncturist | Wellesley Acupuncture Center, 148 Linden Street - #104, Wellesley, MA 02482 | 2006-12-01 |
| 1568574788 | Kathleen Leah Macnaughton Rodrigue | Psychologist | 486 Washington St., Wellesley, MA 02482 | 2006-09-01 |
| 1477660157 | Martin Merovitz | Psychiatry & Neurology | 1a Mayo Rd, Wellesley, MA 02482 | 2006-08-25 |
| Find all providers in zip 02482 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710419957 | Shelby Wozmak | Specialist/Technologist | 32 Lantern Ln, Apt 1, Wellesley, MA 02481-3604 | 2017-03-28 |
| 1720476070 | Janna Berger | Specialist/Technologist | 45 Dana Rd, Wellesley, MA 02482-7043 | 2015-01-08 |
| 1760419709 | Jennifer Grunzweig | Specialist/Technologist | 106 Central St, Keohane Sports Center, Wellesley, MA 02481-8268 | 2006-06-26 |
| 1073555413 | Patricia Lynne Hickey | Specialist/Technologist | 50 Rice St, Whs Athletic Dept, Wellesley, MA 02481-6007 | 2006-06-11 |
| 1588160782 | Robyn Murphy | Specialist/Technologist | 231 Forest St, Wellesley, MA 02481-6834 | 2018-04-05 |
| 1508194358 | Ori Rochbert | Specialist/Technologist | 2 Laurel Ave, Wellesley, MA 02481-7523 | 2009-12-04 |
| 1629271986 | Amanda Elizabeth Rabesa | Specialist/Technologist | 2 Laurel Ave, Wellesley, MA 02481-7523 | 2007-06-06 |
| 1407981863 | Christina Roache | Specialist/Technologist | 2 Laurel Ave, Wellesley, MA 02481-7523 | 2007-02-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184225682 | Jacob Hebert | Specialist/Technologist | 177 Wenonah Rd, Longmeadow, MA 01106-1929 | 2020-11-03 |
| 1700486693 | Mark Comstock | Specialist/Technologist | 74 Union Park St, Boston, MA 02118-2142 | 2020-10-29 |
| 1962000422 | Allison Damigella | Specialist/Technologist | 20 Cobblestone Ln, Bridgewater, MA 02324-2277 | 2020-10-15 |
| 1669088712 | Ryan Donovan | Specialist/Technologist | 4 Paul Ave, Peabody, MA 01960-2620 | 2020-09-23 |
| 1619583119 | Seth Travers | Specialist/Technologist | 179 Wimbleton Dr, Longmeadow, MA 01106-2744 | 2020-09-20 |
| 1306451091 | Stephanie Wilson | Specialist/Technologist | 315 Turnpike St Stop 2247, North Andover, MA 01845-5800 | 2020-09-10 |
| 1467067116 | Devon Choi | Specialist/Technologist | Merrimack College, 315 Turnpike St, North Andover, MA 01845-0184 | 2020-09-10 |
| 1295349140 | Katelyn Charlotte Richardson | Specialist/Technologist | 2002 Lords Ct, Wilmington, MA 01887-4514 | 2020-09-08 |
| 1386256360 | William Conrad Desjardins | Specialist/Technologist | 20 Manhattan Dr, Burlington, MA 01803-1905 | 2020-08-20 |
| 1942812128 | Samantha Norman Kheboian | Specialist/Technologist | 71 Lakeshore Ave, Beverly, MA 01915-1907 | 2020-08-19 |
| Find all providers with the same taxonomy | ||||
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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.