JEREMY MOORE (NPI# 1245596022) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245596022 |
| Entity Type | Individual |
| Full Name | JEREMY MOORE |
| Credential | MD |
| Practice Address |
1 Wyoming St Dayton OH 45409-2722 |
| Mailing Address |
3535 Southern Blvd. Kettering OH 45429-1221 |
| Practice Telephone | 9372083356 |
| Practice Fax Number | 9372083356 |
| Mailing Telephone | 9373846800 |
| Mailing Fax Number | 9373846938 |
| Enumeration Date | 2012-04-06 |
| Last Update Date | 2016-08-24 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 35.122401 | OH | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0095172 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659644821 | Jeremy Scott Moore | Social Worker | 106 Algedon Dr, Bessemer City, NC 28016-2857 | 2012-02-17 |
| 1205128451 | Jeremy Clint Moore | Psychiatry & Neurology | 501 Bishop Lane, University of South Alabama, Department of Psychiatry, Mobile, AL 36608 | 2011-05-06 |
| 1003425117 | Jeremy Moore | Licensed Practical Nurse | 100 Brewster Blvd, Camp Lejeune, NC 28547-2575 | 2020-07-24 |
| 1528419736 | Jeremy Moore | Social Worker | 1101 Weaver Dairy Rd, Suite 103, Chapel Hill, NC 27514-1791 | 2016-06-29 |
| 1265676274 | Jeremy Paul Moore | Pediatrics | 10833 Le Conte Ave, B265, Los Angeles, CA 90095-3075 | 2009-04-22 |
| 1760633622 | Jeremy Moore | Counselor | 3550 Se Woodward St, Portland, OR 97202-1552 | 2008-10-08 |
| 1295877140 | Jeremy Patrick Moore | Anesthesiology | 9300 Dewitt Loop, Fort Belvoir, VA 22060-5285 | 2007-02-13 |
| 1184707143 | Jeremy Adam Moore | Otolaryngology | 3650 W Rock Creek Rd, Suite 110, Norman, OK 73072-2202 | 2006-10-23 |
| 1548360290 | Jeremy Emmett Moore | Dentist | 8254 One Calais Ave, Suite 100, Baton Rouge, LA 70809-3450 | 2006-09-23 |
| Street Address |
1 WYOMING ST |
| City | DAYTON |
| State | OH |
| Zip Code | 45409-2722 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235134180 | Christopher Scott Croom | Obstetrics & Gynecology | 1 Wyoming St, Berry Bldg, Ground Fl, Dayton, OH 45409-2722 | 2005-06-16 |
| 1902412133 | Dustin Logan Warne | Registered Nurse | 1 Wyoming St, Dayton, OH 45409-2722 | 2020-09-22 |
| 1356956965 | Yeri Noh | Pharmacist | 1 Wyoming St, Dayton, OH 45409-2722 | 2020-09-10 |
| 1457965642 | Amanda Danielle Boykin | Nurse Practitioner | 1 Wyoming St, Dayton, OH 45409-2722 | 2020-09-03 |
| 1386257046 | Daryl Brown | Physician Assistant | 1 Wyoming St, Dayton, OH 45409-2711 | 2020-08-24 |
| 1518578624 | Mary Goeller | Physician Assistant | 1 Wyoming St, Dayton, OH 45409-2722 | 2020-08-12 |
| 1033720545 | Emily Newport | Pharmacist | 1 Wyoming St, Dayton, OH 45409-2722 | 2020-08-10 |
| 1447869433 | David Mark Peters Jr. | Pharmacist | 1 Wyoming St, Dayton, OH 45409-2722 | 2020-07-27 |
| 1376151787 | Zachary Sahadak | Pharmacist | 1 Wyoming St, Dayton, OH 45409-2722 | 2020-07-22 |
| 1093323339 | Mckenzie Shenk | Pharmacist | 1 Wyoming St, Dayton, OH 45409-2722 | 2020-07-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487276457 | Matthew R Schaeffer | Surgery | 128 E Apple St., Wche 7th Floor, Dayton, OH 45409 | 2020-05-13 |
| 1699237545 | Elizabeth Joan Hudson | Student in an Organized Health Care Education/Training Program | 1 Wyoming Street Miami Valley Hospital Medical Educatio, Dayton, OH 45409 | 2019-04-01 |
| 1760941066 | Courtney Lyn Johnson | Surgery | 128 East Apple Street, Wche 7th Floor, Dayton, OH 45409 | 2019-03-16 |
| 1477057529 | Adam Joseph Langer | Student in an Organized Health Care Education/Training Program | 128 E. Apple St Suite 3800, Wright State University Dept of Ob/gyn, Dayton, OH 45409 | 2018-03-22 |
| 1659870939 | Timothy Wall | Student in an Organized Health Care Education/Training Program | 128 East Apple St., 2nd Floor, Dayton, OH 45409 | 2018-02-01 |
| 1124551411 | Adam Schmerge Deardorff | Student in an Organized Health Care Education/Training Program | 30 E Apple St Ste 6257, Dayton, OH 45409 | 2017-04-04 |
| 1205205358 | Kelby Snorf | Physician Assistant | 30 E Apple Street, Suite 3300, Dayton, OH 45409 | 2015-09-18 |
| 1689054223 | Jessica Ezinne Ugwu | Family Medicine | 30 E Apple St., Suite Nw 3300, Dayton, OH 45409 | 2015-06-08 |
| 1679983084 | Jude Anneryan Cohen | Registered Nurse | 1200 W. Dorothy Lane, Southdale Elementary School, Kettering, OH 45409 | 2014-05-07 |
| 1730517087 | Jesse Wayne Clark | Counselor | 65 Grady Ct, Dayton, OH 45409 | 2013-10-24 |
| Find all providers in zip 45409 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275875437 | Stephanie I Haddad | Emergency Medicine | 10 Julia Way, Dayton, NJ 08810-1308 | 2013-03-26 |
| 1679702294 | Leslie Rae Dye | Emergency Medicine | 601 South Edwin C Moses Rd, Dayton, OH 45417-3424 | 2009-07-02 |
| 1215080049 | Charles Mcintosh | Emergency Medicine | 405 W. Grand Avenue, Dayton, OH 45405-4796 | 2007-01-18 |
| 1134210347 | Bryan T. Fitzgerald | Emergency Medicine | 5664 Stone Lake Dr, Dayton, OH 45429-6001 | 2006-09-27 |
| 1558851568 | Emergency Medicine Specialists, Inc. | Emergency Medicine | 405 W Grand Ave, Dayton, OH 45405-7538 | 2018-05-15 |
| 1710410998 | Justin Jefferey Lake | Emergency Medicine | 405 W Grand Ave, Dayton, OH 45405-7538 | 2017-04-05 |
| 1053843870 | Vincent Christopher Marsh | Emergency Medicine | 1 Wyoming St, Dayton, OH 45409-2722 | 2017-03-30 |
| 1215390455 | Bonnie Marmora | Emergency Medicine | 4881 Sugar Maple Dr, Dayton, OH 45433-5529 | 2016-04-04 |
| 1952780322 | Adam Wiercinski | Emergency Medicine | 405 W Grand Ave, Medical Education Department, Dayton, OH 45405-4720 | 2015-05-19 |
| 1477931871 | Keri Alison Childers | Emergency Medicine | 405 W Grand Ave, Medical Education Department, Dayton, OH 45405-4720 | 2015-05-18 |
| Find all providers in DAYTON | ||||
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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.