CANDICE M. MOORE (NPI# 1174699011) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174699011 |
| Entity Type | Individual |
| Full Name | CANDICE M. MOORE |
| Credential | OTR L |
| Practice Address |
4500 Interstate 55 North Suite 291, Highland Village Jackson MS 39211 |
| Mailing Address |
766 Clearmont Dr Pearl MS 39208-6261 |
| Practice Telephone | 6013620859 |
| Practice Fax Number | 6013620870 |
| Enumeration Date | 2006-11-24 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225X00000X | Occupational Therapist | OT1713 | MS | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 05170357 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578047338 | Candice Moore | Counselor | 1375 Camilla Dr, Greenville, NC 27834-9556 | 2018-09-18 |
| 1629555131 | Candice M. Moore | Optometrist | 4465 Jimmy Lee Smith Pkwy Ste 101, Hiram, GA 30141-2723 | 2018-07-26 |
| 1538565106 | Candice Moore | Occupational Therapist | 105a Windmill Cv, Grenada, MS 38901-9305 | 2014-11-10 |
| 1447884846 | Candice Renee Moore | Nurse Practitioner | 7400 E Thompson Peak Pkwy, Scottsdale, AZ 85255-4109 | 2020-02-25 |
| 1972043131 | Candice Diane Moore | Nurse Practitioner | 2201 Forest Ln, Garland, TX 75042-7957 | 2017-03-06 |
| 1902257165 | Candice Nicole Moore | Nurse Practitioner | 950 Brookway Blvd, Brookhaven, MS 39601-2644 | 2016-06-28 |
| 1558745042 | Candice Gail Moore | Counselor | 10601 Grant Rd, Suite 115b, Houston, TX 77070-4400 | 2015-07-14 |
| 1881932770 | Candice Moore | Physical Therapist | 2 Keewaydin Dr, Salem, NH 03079-2839 | 2013-01-28 |
| 1326013228 | Candice A. Moore | Psychiatry & Neurology | 815 S Ash St, Nevada, MO 64772-3222 | 2006-02-22 |
| Street Address |
4500 INTERSTATE 55 NORTH SUITE 291, HIGHLAND VILLAGE |
| City | JACKSON |
| State | MS |
| Zip Code | 39211 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134135783 | James David Herzog | Psychologist | 4500 Interstate 55 North, Suite 208, Jackson, MS 39211-5931 | 2006-08-01 |
| 1629145255 | Laskin Therapy Group, P.a. | Physical Therapist | 4500 Interstate 55 North, Suite 291, Highland Village, Jackson, MS 39211 | 2006-11-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760092878 | Bio-medical Applications of Mississippi, Inc. | Clinic/Center | 5722 I-55 N Frontage Road, Jackson, MS 39211 | 2020-08-04 |
| 1548881048 | Gloria Dansby-giles | Counselor | 4500 Interstate 55, North; Suite 220, Jackson, MS 39211 | 2020-05-06 |
| 1821628223 | Alice Powell Taylor | St. Dominic Weight Loss Solutions, 3800 Interstate 55 North Frontage Road Suite 102, Jackson, MS 39211 | 2020-01-24 | |
| 1356980643 | Bethany Powers | Pharmacist | 4910 Interstate 55 North Frontage Rd, Jackson, MS 39211 | 2020-01-03 |
| 1316585581 | Deborah Magoun Rosenbaum | Pharmacist | [email protected], 4910 I-55 North, Jackson, MS 39211 | 2019-12-18 |
| 1285108357 | Eric Wood | Counselor | 4623 Maurey Rd, Jackson, MS 39211 | 2019-01-11 |
| 1649758301 | Isluv Robertson | Registered Nurse | 1405 E Northside Dr, Jackson, MS 39211 | 2018-08-03 |
| 1659863066 | Jonbrighton Childs Russell | Student in an Organized Health Care Education/Training Program | 4343 Dalrymple Ct, Jackson, MS 39211 | 2018-05-31 |
| 1225557598 | Regina Ann Day | Dietitian, Registered | 3800 I 55 North Frontage Road, Jackson, MS 39211 | 2017-09-18 |
| 1023558525 | Agilitas Usa Inc | Clinic/Center | 120 District Blvd E, Suite D102, Jackson, MS 39211 | 2017-03-02 |
| Find all providers in zip 39211 | ||||
| Taxonomy Code | 225X00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Occupational Therapist |
| An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork experience required by the occupational therapy program; has passed a nationally recognized entry-level examination for occupational therapists, and fulfills state requirements for licensure, certification, or registration. An occupational therapist provides interventions based on evaluation and which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapists address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life. |
| Notes: Source: The Guide to Occupational Therapy Practice, 2nd edition. Bethesda: American Occupational Therapy Association, 2007. [7/1/2008: definition changed, added source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326649740 | Madison Mcbride | Occupational Therapist | 442 Redmond St, Jackson, WY 83001-8451 | 2020-11-03 |
| 1336763135 | Jill Elaine Beattie Green | Occupational Therapist | 100 Ky-15, Jackson, KY 41339 | 2020-06-08 |
| 1619517869 | Cristen N Sudduth | Occupational Therapist | 374 Savanna St, Jackson, MS 39212-5257 | 2020-01-15 |
| 1144869892 | Jill Garaffa | Occupational Therapist | 6 Three Pence Ln, Jackson, NJ 08527-2256 | 2019-12-29 |
| 1821565383 | Brynn Corbello | Occupational Therapist | 5140 Galaxie Dr, Jackson, MS 39206-4335 | 2018-11-01 |
| 1205302601 | Christopher Charles Patania | Occupational Therapist | 2890 Noon Rd, Jackson, MI 49201-9134 | 2018-10-23 |
| 1770014300 | Haley Morris | Occupational Therapist | 556 N Donna Dr, Jackson, MO 63755-8080 | 2017-03-24 |
| 1174072920 | Fortunato Alipala | Occupational Therapist | 320 Hidden Meadows Dr, Jackson, MO 63755-3274 | 2016-09-21 |
| 1992252423 | Joshua Muchnick | Occupational Therapist | 826 Green Valley Road, Jackson, NJ 08527-2944 | 2016-09-01 |
| 1134591423 | Eleazar Kapunan | Occupational Therapist | 21 Silvercrest Cv, Jackson, TN 38305-7862 | 2015-10-26 |
| Find all providers in JACKSON | ||||
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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.