MRS. JENNIFER PRUITT MOORE (NPI# 1184631582) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184631582 |
| Entity Type | Individual |
| Full Name | MRS. JENNIFER PRUITT MOORE |
| Credential | L.P.C. |
| Practice Address |
524 Signal Hill Drive Ext Statesville NC 28625-4391 |
| Mailing Address |
284 Executive Park Dr Ste 100 Concord NC 28025-1833 |
| Practice Telephone | 7048711045 |
| Mailing Telephone | 7049391100 |
| Mailing Fax Number | 7049391173 |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2017-08-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
5257 | NC | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 1184631582 | 05 | |
| NC | 6103396 | 05 | |
| SC | PC1484 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215536370 | Jennifer Lynn Moore | Nurse Practitioner | 203 N College Ave Ste 1001, Cleveland, TX 77327-2500 | 2020-10-20 |
| 1790332104 | Jennifer Dawn Moore | Technician | 3154 Jackson Bridge Rd, Carnesville, GA 30521-4126 | 2019-08-20 |
| 1427522192 | Jennifer G Moore | Speech-Language Pathologist | 2500 Cherry Ln, Northbrook, IL 60062-4414 | 2019-01-16 |
| 1548735632 | Jennifer Moore | Counselor | 11706 W Chenango Dr Apt 3, Morrison, CO 80465-2020 | 2018-10-04 |
| 1295218667 | Jennifer Elaine Moore | Registered Nurse | 185 Vz Cr 2103, Canton, TX 75103 | 2018-09-12 |
| 1942788104 | Jennifer Heine Moore | Licensed Vocational Nurse | 315 S Grand Saline St, Canton, TX 75103-1355 | 2018-07-31 |
| 1134639636 | Jennifer A Moore | Psychologist | 310 S Walnut Bend Rd Ste 2, Cordova, TN 38018-7282 | 2017-10-10 |
| 1346778214 | Jennifer Moore | Counselor | 348 Prior Ave N Ste 205, Saint Paul, MN 55104-5591 | 2017-05-23 |
| 1194263665 | Jennifer Moore | Occupational Therapist | 6540 Havens Corners Rd, Blacklick, OH 43004-8415 | 2017-02-06 |
| 1790237329 | Jennifer Moore | Student in an Organized Health Care Education/Training Program | 281 Winter St Ste 240, Waltham, MA 02451-8713 | 2016-10-31 |
| Street Address |
524 SIGNAL HILL DRIVE EXT |
| City | STATESVILLE |
| State | NC |
| Zip Code | 28625-4391 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598385338 | Lisa Scott | Clinical Nurse Specialist | 524 Signal Hill Drive Ext, Statesville, NC 28625-4391 | 2020-04-22 |
| 1982235149 | Benny Allen Suttles | Clinical Nurse Specialist | 524 Signal Hill Drive Ext, Statesville, NC 28625-4391 | 2020-01-27 |
| 1437796737 | Nickysha Mckoy | Licensed Practical Nurse | 524 Signal Hill Drive Ext, Statesville, NC 28625-4391 | 2019-12-05 |
| 1265093850 | Kristina Marie Sheybani-agdam | Licensed Practical Nurse | 524 Signal Hill Drive Ext, Statesville, NC 28625-4391 | 2019-06-24 |
| 1386105286 | Deshannon Daniels | Licensed Practical Nurse | 524 Signal Hill Drive Ext, Statesville, NC 28625-4391 | 2019-03-26 |
| 1568923407 | Linda Caroline Roberts | Clinical Nurse Specialist | 524 Signal Hill Drive Ext, Statesville, NC 28625-4391 | 2019-03-25 |
| 1700340981 | Stephanie Kennedy | Licensed Practical Nurse | 524 Signal Hill Drive Ext, Statesville, NC 28625-4391 | 2019-01-22 |
| 1033691415 | Tashe Alexandria Jones | Licensed Practical Nurse | 524 Signal Hill Drive Ext, Statesville, NC 28625-4391 | 2018-09-03 |
| 1619458619 | David John Miller II | Social Worker | 524 Signal Hill Drive Ext, Statesville, NC 28625-4391 | 2018-08-27 |
| 1194210815 | Amy Sherrill | Clinical Nurse Specialist | 524 Signal Hill Drive Ext, Statesville, NC 28625-4391 | 2018-06-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730714163 | Sandra Lourdes Mayta | Counselor | 1450 Fern Creek Drive, Statesville, NC 28625 | 2020-03-05 |
| 1023643582 | Youngchi Chang Dds Pllc | Dentist | 964 Glenway Ave Ste A, Statesville, NC 28625 | 2020-03-05 |
| 1538799200 | Nicole-marie Blischak | Dentist | 964 Glenway Dr, Ste A, Statesville, NC 28625 | 2020-01-22 |
| 1013575257 | Sherry Neilson | Registered Nurse | 524 Signal Hill Rd, Statesville, NC 28625 | 2019-06-03 |
| 1770904328 | Elinor Kyle Tyner | Counselor | 1206 Museum Road, Statesville, NC 28625 | 2013-12-30 |
| 1982031001 | Tamiko Bradley | Counselor | 524 Signal Hill Dr Ext, Statesville, NC 28625 | 2013-10-03 |
| 1487932505 | Nicole Weisner Winecoff | Advanced Practice Midwife | 1420 Fern Creek Drive, Statesville, NC 28625 | 2011-07-22 |
| 1538461967 | Bethany J Sprague | Nurse Practitioner | 2632 Fines Creek Dr, Statesville, NC 28625 | 2010-11-17 |
| 1477789147 | Greenbriar Primary Care, Pa | Nurse Practitioner | 308-c Mocksville Highway, Statesville, NC 28625 | 2009-06-08 |
| 1619122538 | Phasebdevelopment | Substance Abuse Rehabilitation Facility | 113 Bethany Rd, Statesville, NC 28625 | 2008-11-19 |
| Find all providers in zip 28625 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861014797 | Savannah Jane Nevarez | Counselor | 1450 Fern Creek Dr, Statesville, NC 28625-9376 | 2020-05-14 |
| 1023465648 | Joel Devine | Counselor | 155 Elmwood Rd, Statesville, NC 28625-1101 | 2016-05-24 |
| 1063887487 | Jennifer W Dalton | Counselor | 151 Zurich Ln, Statesville, NC 28625-5002 | 2015-12-10 |
| 1912378878 | Katherine Lee Wimberly | Counselor | 1835 Davie Ave Ste 411, Statesville, NC 28677-3578 | 2015-10-16 |
| 1033595426 | Johannah Robinette | Counselor | 3355 Wilkesboro Hwy, Statesville, NC 28625-1235 | 2015-08-07 |
| 1427437391 | Jodi Province Counseling Services Pllc | Counselor | 1605 Norwood Rd, Statesville, NC 28677-8201 | 2015-05-26 |
| 1770904328 | Elinor Kyle Tyner | Counselor | 1206 Museum Road, Statesville, NC 28625 | 2013-12-30 |
| 1043510910 | Mark L Powers | Counselor | 110b Stockton St Ste B, Statesville, NC 28677-5244 | 2010-10-26 |
| 1609185016 | Linda Sue Smith | Counselor | 333 Brookdale Dr Ste B, Statesville, NC 28677-4190 | 2010-10-02 |
| 1366677163 | Mark Anthony Vaughn | Counselor | 129 W Tattersall Dr, Statesville, NC 28677-2054 | 2009-05-21 |
| Find all providers in STATESVILLE | ||||
| City | STATESVILLE |
| Zip Code | 28625 |
Please comment or provide details below to improve the information on MRS. JENNIFER PRUITT MOORE.
| 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.