JENNIFER E. MOORE (NPI# 1275513830) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275513830 |
| Entity Type | Individual |
| Full Name | JENNIFER E. MOORE |
| Practice Address |
405 Arrowhead Blvd Ste C Jonesboro GA 30236-1254 |
| Mailing Address |
2455 Harrington Dr Decatur GA 30033-4903 |
| Practice Telephone | 7704789877 |
| Practice Fax Number | 7704782908 |
| Mailing Telephone | 4043156081 |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2012-04-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367H00000X | Anesthesiologist Assistant | 003360 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 100000534A | 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 |
405 ARROWHEAD BLVD STE C |
| City | JONESBORO |
| State | GA |
| Zip Code | 30236-1254 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720633340 | Julia Conley | Speech-Language Pathologist | 405 Arrowhead Blvd Ste C, Jonesboro, GA 30236-1254 | 2019-08-09 |
| 1932765765 | Kayla Deloach | Occupational Therapist | 405 Arrowhead Blvd Ste C, Jonesboro, GA 30236-1254 | 2019-05-16 |
| 1760045975 | Madalyn Kay Hart | Speech-Language Pathologist | 405 Arrowhead Blvd Ste C, Jonesboro, GA 30236-1254 | 2019-04-15 |
| 1275044901 | Erin Irene Jamieson | Speech-Language Pathologist | 405 Arrowhead Blvd Ste C, Jonesboro, GA 30236-1254 | 2017-10-20 |
| 1023404001 | Jasmine Philpot | Speech-Language Pathologist | 405 Arrowhead Blvd Ste C, Jonesboro, GA 30236-1254 | 2015-04-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972123362 | Life Source Counseling & Consulting, LLC | Clinic/Center | 118 North Avenue, Suite A, Jonesboro, GA 30236 | 2020-04-25 |
| 1639609555 | New Beginnings Behavioral Counseling,llc | Social Worker | 9456 S Main St Ste E2, Jonesboro, GA 30236 | 2017-06-13 |
| 1437696762 | Clarissa Alexandra Poole | Counselor | 2106 Fair Ridge Ct, Jonesboro, GA 30236 | 2017-01-25 |
| 1588012892 | Sundance Healthcare Service Inc | In Home Supportive Care | 7861 Collinswood Court, Jonesboro, GA 30236 | 2016-05-26 |
| 1942669205 | Adrianne Smiley Gurley | Occupational Therapist | 1299 Battlecreek Rd Ste 210, Jonesboro, GA 30236 | 2016-02-15 |
| 1336505809 | Integrated Health Center | Dentist | 8600 Tara Blvd, Suite D, Jonesboro, GA 30236 | 2016-01-13 |
| 1467827402 | Surrell Porter | Nurse Practitioner | 1287 Georgia Highway 138 Spur, Suite 8, Jonesboro, GA 30236 | 2015-12-02 |
| 1740688910 | Jacqueline Carolyn Edwards | Registered Nurse | 8081 Tara Blvd, 265, Jonesboro, GA 30236 | 2014-12-19 |
| 1770991861 | Lower Extremity Diagnostics, LLC | Podiatrist | 6911 Tara Boulevard, Jonesboro, GA 30236 | 2014-08-01 |
| 1760899710 | Fresenius Medical Care Jonesboro, LLC | Clinic/Center | 8060 Summitt Business Parkway, Jonesboro, GA 30236 | 2014-07-22 |
| Find all providers in zip 30236 | ||||
| Taxonomy Code | 367H00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Anesthesiologist Assistant |
| An individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants are required to have a bachelor's degree with a premed curriculum prior to entering a two-year anesthesiology assistant program, which is focused upon the delivery and maintenance of anesthesia care as well as advanced patient monitoring techniques. An Anesthesiologist Assistant must work as a member of the anesthesia care team under the direction of a qualified Anesthesiologist. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003366873 | Minh Lam Tang | Anesthesiologist Assistant | 7813 Spivey Station Blvd, Jonesboro, GA 30236 | 2016-10-05 |
| 1841453875 | Jianmei Li | Anesthesiologist Assistant | 405 Arrowhead Blvd, Suite C, Jonesboro, GA 30236-1254 | 2008-07-09 |
| 1104084201 | Allison R Johns | Anesthesiologist Assistant | 405 Arrowhead Blvd, Suite C, Jonesboro, GA 30236-1254 | 2008-05-27 |
| 1740481381 | Jared Charles Kutzer | Anesthesiologist Assistant | 405 Arrowhead Blvd, Suite C, Jonesboro, GA 30236-1254 | 2007-05-30 |
| 1205937810 | Edward C Cardinal | Anesthesiologist Assistant | 405 Arrowhead Blvd, Suite C, Jonesboro, GA 30236-1254 | 2006-09-26 |
| 1669577144 | Julian C Gist | Anesthesiologist Assistant | 405 Arrowhead Blvd, Jonesboro, GA 30236-1254 | 2006-09-13 |
| 1679685697 | Vadim Lvovich | Anesthesiologist Assistant | 405 Arrowhead Blvd, Suite C, Jonesboro, GA 30236-1254 | 2006-08-31 |
| 1639142219 | Christian Pham | Anesthesiologist Assistant | 405 Arrowhead Blvd, Suite C, Jonesboro, GA 30236-1254 | 2006-02-13 |
| 1558331678 | Thomas Simmons | Anesthesiologist Assistant | 405 Arrowhead Blvd, Suite C, Jonesboro, GA 30236-1254 | 2006-01-23 |
| 1033199534 | Yvonne A. Seaward | Anesthesiologist Assistant | 405 Arrowhead Blvd, Jonesboro, GA 30236-1254 | 2006-01-19 |
| Find all providers in JONESBORO | ||||
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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.