JACK C MOORE II (NPI# 1164443529) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164443529 |
| Entity Type | Individual |
| Full Name | JACK C MOORE II |
| Credential | MD |
| Practice Address |
175 S English Station Rd Ste 226 Louisville KY 40245 |
| Mailing Address |
100 E Liberty St Ste 800 Louisville KY 40202-1428 |
| Practice Telephone | 5022440911 |
| Practice Fax Number | 5022530581 |
| Mailing Telephone | 5022440911 |
| Mailing Fax Number | 5022530581 |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2019-08-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 34365 | KY | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 01069727A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 64040173 | 05 | |
| KY | MEDICARE RAILROAD | P01073440 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 515 Hospital Dr Ste 1, Shelbyville, KY 400651619 | 5026333525 | 5026338075 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982890331 | Jack Lowell Moore | Dentist | 700 Sunrise Avenue, Suite C, Roseville, CA 95661-4561 | 2007-09-19 |
| 1891063236 | Jack Moore | Optometrist | 3700 Martin Way E, #101, Olympia, WA 98506-5052 | 2011-12-13 |
| 1568470011 | Jack L Moore | Nurse Practitioner | 777 Bannock St, Mc 7782, Denver, CO 80204-4507 | 2006-08-03 |
| 1235170812 | Jack W Moore | Orthopaedic Surgery | 4715 Whitesburg Dr S, Huntsville, AL 35802-1632 | 2006-06-08 |
| 1104876606 | Jack D Moore | Specialist | 4321 Washington St, 5300, Kansas City, MO 64111-5961 | 2006-05-12 |
| 1467426221 | Jack Moore | Specialist | 3800 Reservoir Rd Nw, Washington, DC 20007-2113 | 2006-02-16 |
| Street Address |
175 S ENGLISH STATION RD STE 226 |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40245 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174524821 | Lisa Leigh Corum | Family Medicine | 175 S English Station Rd Ste 226, Louisville, KY 40245-4199 | 2005-08-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083247753 | Stepping Stones Pediatric Therapy, LLC | Early Intervention Provider Agency | 330 Cranbury Way, Louisville, KY 40245 | 2020-02-20 |
| 1790324333 | Joseph Strano | Pharmacist | 12450 Lagrange Road, Louisville, KY 40245 | 2019-12-30 |
| 1174160725 | Anne S Hill | Technician | 16621 Taunton Vale Rd, Louisville, KY 40245 | 2019-12-03 |
| 1750808937 | Amy Judy | Assistant Behavior Analyst | 4512 Meadowlark Manor Dr, Louisville, KY 40245 | 2017-08-28 |
| 1104356567 | Mmr Cardiovascular Consulting LLC | Internal Medicine | 1101 Glenlake Way, Louisville, KY 40245 | 2017-06-18 |
| 1952830135 | Staci Marie Trofimov | Dietitian, Registered | 13008 Willow Forest Drive, Louisville, KY 40245 | 2017-06-09 |
| 1629524913 | Forefront Dermatology, S.c. | Dermatology | 159 S. English Station Road, Louisville, KY 40245 | 2016-08-28 |
| 1861867830 | Jamila Hadden | Counselor | 111 Parkview Dr., Louisville, KY 40245 | 2015-12-02 |
| 1538570312 | Brian Johnson | Case Manager/Care Coordinator | 4717 Middlesex Drive, 4717 Middlesex Drive, Louisville, KY 40245 | 2014-05-14 |
| 1033535828 | Genesis Eldercare Physician Services LLC | Nurse Practitioner | 16605 Chestnut Glen Pl, Louisville, KY 40245 | 2014-03-17 |
| Find all providers in zip 40245 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548883960 | Proactive Md Ky Psc | Family Medicine | 4340 Crittenden Dr, Louisville, KY 40209-1600 | 2020-05-20 |
| 1437616794 | Paladina Health, LLC | Family Medicine | Paladina Health Humana East, 123 E Main Street, Louisville, KY 40202 | 2019-02-22 |
| 1205393568 | Paladina Health, LLC | Family Medicine | Paladina Health Humana West, 500 W Main Street, Louisville, KY 40202 | 2019-02-22 |
| 1639636988 | Paladina Health, LLC | Family Medicine | Paladina Health Louisville Park Plaza, 9720 Park Plaza Avenue #101, Louisville, KY 40241 | 2019-02-22 |
| 1619434974 | Paladina Health, LLC | Family Medicine | Paladina Health Louisville Centerstone Broadway, 914 East Broadway Suite 200, Louisville, KY 40204 | 2019-02-22 |
| 1558844027 | Arthur James Shulthise Jr. | Family Medicine | Bldg. 2801 - Bowman Field, 2801 Taylorsville Road, Louisville, KY 40205 | 2018-09-11 |
| 1104341171 | Brandy Wells | Family Medicine | 11612 Top Walnut Loop, Louisville, KY 40229 | 2017-08-10 |
| 1437679842 | Michael Edward Lovelace | Family Medicine | 1800 Stevens Avenue, Louisville, KY 40205 | 2017-06-27 |
| 1770939043 | Rss Inc Dba Mediweightloss | Family Medicine | 166 N Hurstbourne Pkwy, Louisville, KY 40222-5108 | 2016-05-05 |
| 1104280379 | Jonathan Paul Newsom | Family Medicine | 2401 Terra Crossing Blvd Ste 101, Louisville, KY 40245-5371 | 2016-04-13 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40245 |
Please comment or provide details below to improve the information on JACK C MOORE II.
| 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.