DR. SHANNON MONIQUE MOORE


Address: 1675 Lakeland Dr Ste 304, Jackson, MS 39216
Phone: 7695244578

DR. SHANNON MONIQUE MOORE (NPI# 1154636611) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1154636611
Entity Type Individual
Full Name DR. SHANNON MONIQUE MOORE
Credential PHD
Practice Address 1675 Lakeland Dr Ste 304
Jackson
MS 39216
Mailing Address Po Box 13563
Jackson
MS 39236-3563
Practice Telephone 7695244578
Practice Fax Number 7695244630
Mailing Telephone 7695244578
Mailing Fax Number 7695244630
Enumeration Date 2010-08-09
Last Update Date 2019-03-22
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103TC0700X Psychologist
Specialization: Clinical
55981 MS Behavioral Health & Social Service Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
1818 Albion St Ste 114, Nashville, TN 372082918 6153274751

Other Providers SHANNON MOORE

NPI Name Taxonomy Address Enumeration
1043825565 Shannon Roberta Moore In Home Supportive Care 5686 Broadview Rd Apt 2520, Parma, OH 44134-1647 2020-09-11
1033764055 Shannon Moore Physical Therapist 235 Open Sky Way, Kila, MT 59920-7700 2019-08-06
1770006660 Shannon Moore Optometrist 340 Wood Rd Ste 2020, Braintree, MA 02184-2404 2017-07-21
1316327851 Shannon Moore Technician, Other 24837 Princeton St, Dearborn, MI 48124-4457 2015-05-30
1659713071 Shannon Lori Moore Dietitian, Registered 1114 Thomasville Rd Ste G, Tallahassee, FL 32303-6273 2013-07-26
1326388893 Shannon Michelle Moore Developmental Therapist 340 Ralley Rd, Keavy, KY 40737-2729 2013-02-21
1639414345 Shannon L Moore Licensed Practical Nurse 1235 3rd Street, Sedro-woolley, WA 98284 2012-12-06
1669767208 Shannon M Moore Pharmacist 80 Baker St, Richmond, VT 05477-7750 2011-06-11
1689630246 Shannon Jessica Moore Optometrist 528 Waterloo Rd, Warrenton, VA 20186-3011 2006-04-24
1144863176 Shannon Moore Behavior Technician 901 O St, Suite C, Arcata, CA 95521-5789 2019-10-22

Office Location

Street Address 1675 LAKELAND DR STE 304
City JACKSON
State MS
Zip Code 39216

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1861011553 Ashley Melancon Prewitt Registered Nurse St. Dominic's North Campus, Behavioral Health, Jackson, MS 39216 2020-04-13
1194353391 Brianna Arrington Student in an Organized Health Care Education/Training Program Med/ Peds, 2500 N. State St., Jackson, MS 39216 2020-04-01
1720616485 Roshina Khalid Khan Student in an Organized Health Care Education/Training Program Department of Anesthesiology, Ummc, 2500 N. State St., Jackson, MS 39216 2020-03-30
1275183550 Amanda Lynn Morellato Dentist Ummc School of Dentistry, 2500 North State Street, Jackson, MS 39216 2019-09-18
1396305553 Abhishek Chhabra Student in an Organized Health Care Education/Training Program Lakeland Family Medicine Clinic, 878 Lakeland Dr., Jackson, MS 39216 2019-06-19
1427615996 Hometown Diagnostics Clinical Medical Laboratory Translational Research Center Tr311, 2500 North State Street, Jackson, MS 39216 2019-05-21
1346807773 Shukundala C Smith Behavior Technician New Learning Resources 2510 Lakeland Terrace, Jackson, MS 39216 2019-05-21
1063901098 G Eli Howell Md Pllc Plastic Surgery 971 Lakeland Dr Ste 225, Jackson, MS 39216 2018-05-04
1588168132 Caleb Zumbro Student in an Organized Health Care Education/Training Program Ummc Med/peds, 2500 N. State St., Jackson, MS 39216 2018-03-20
1639677230 Walgreen Co Pharmacy 971 Lakeland Dr Ste 101, Jackson, MS 39216 2018-01-29
Find all providers in zip 39216

Taxonomy Information

Taxonomy Code 103TC0700X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization Clinical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1043756174 Maribeth L. Hesser Psychologist 6675 N Upper Cascade Dr, Jackson, WY 83001-9390 2017-01-12
1215375746 Payne Behavioral Medicine Psychologist 4005 N State St Ste N, Jackson, MS 39206-5755 2013-06-06
1598002610 Kimberly D Weaver Psychologist 207 First Street, Jackson, MI 49201 2013-01-09
1497027775 Fitness Clinic Psychologist 2219 Greenway Dr, Jackson, MS 39204-3202 2012-02-02
1760752976 Mitchell S. Weisbrod, Psy.d., Pllc Psychologist 115 S West Ave Ste 1, Jackson, MI 49201-2085 2012-01-04
1275830887 Martin E Cleveland Phd Pllc Psychologist 5 Brentmeade Cv, Jackson, TN 38305-6448 2011-02-16
1598076903 Nanetta S Payne Psychologist 4005 N State St, Suite N, Jackson, MS 39206-5755 2010-06-30
1932422763 Marion Counseling Services, Pllc Psychologist 2095 Dunbarton Dr, Suite 103, Jackson, MS 39216-5017 2010-03-08
1457548737 Deborah Ruddy Hansen Psychologist 6 Universal Way, Jackson, MI 49202-1455 2007-10-01
1902006737 Ena C Knott-scott Psychologist 1264 Wooddell Dr, Jackson, MS 39212-4045 2007-07-19
Find all providers in JACKSON

Competitor

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City JACKSON
Zip Code 39216

Improve Information

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Dataset Information

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.

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