SPENCER KEITH MOORE


Address: 1804 Highway 45 Byp, Suite 604, Jackson, TN 38305-4436
Phone: 7316607971

SPENCER KEITH MOORE (NPI# 1770928517) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1770928517
Entity Type Individual
Full Name SPENCER KEITH MOORE
Credential CW
Practice Address 1804 Highway 45 Byp
Suite 604
Jackson
TN 38305-4436
Mailing Address 2035 Saint John Ave
Dyersburg
TN 38024-2209
Practice Telephone 7316607971
Practice Fax Number 7316608739
Mailing Telephone 7315418200
Mailing Fax Number 7316608739
Enumeration Date 2013-05-07
Last Update Date 2014-09-08
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 171M00000X Case Manager/Care Coordinator Other Service Providers

Other Providers SPENCER MOORE

NPI Name Taxonomy Address Enumeration
1710535778 Spencer Elise Moore Optometrist 100 N Tryon St Ste 280, Charlotte, NC 28202-4004 2019-09-03
1497794192 Spencer V Moore Optometrist 1215 Lake Air Dr, Waco, TX 76710-4419 2006-06-06
1235750670 Spencer Moore Internal Medicine 1501 N Campbell Ave, Tucson, AZ 85724-5040 2020-04-27
1083257216 Spencer Gabriel Moore Case Manager/Care Coordinator 602 David St, Corning, AR 72422-7268 2019-10-21
1831604396 Spencer Edmund Moore Behavior Technician 1260 Ekhart St Ne, Grand Rapids, MI 49503-1380 2017-12-06
1285165530 Spencer Harding Moore Student in an Organized Health Care Education/Training Program 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 2017-03-27

Office Location

Street Address 1804 HIGHWAY 45 BYP
SUITE 604
City JACKSON
State TN
Zip Code 38305-4436

Providers in the same location

NPI Name Taxonomy Address Enumeration
1104816966 Jackson-madison County General Hospital Hospice Care, Community Based 1804 Highway 45 Byp, Jackson, TN 38305-4436 2005-10-24
1750788352 Sharon Brown Counselor 1804 Highway 45 Byp, Suite 604, Jackson, TN 38305-4436 2014-11-25
1285908210 Bobby Clark Higgs Family Medicine 1804 Highway 45 Byp, Suite 100, Jackson, TN 38305-4436 2012-03-08
1386809903 Robert Dale Silvia Nurse Anesthetist, Certified Registered 1804 Highway 45 Byp, Suite 604, Jackson, TN 38305-4436 2008-07-23
1275798894 Eric Marshall Olexa Registered Nurse 1804 Highway 45 Byp, Suite 604, Jackson, TN 38305-4436 2008-07-23
1942465588 Megan Christine Clampitt Nurse Anesthetist, Certified Registered 1804 Highway 45 Byp, Suite 604, Jackson, TN 38305-4436 2008-07-23
1578728119 Ginger Brasfield Nurse Anesthetist, Certified Registered 1804 Highway 45 Byp, Suite 604, Jackson, TN 38305-4436 2008-07-23
1821269986 Samantha Soares Counselor 1804 Highway 45 Byp, Suite 604, Jackson, TN 38305-4436 2008-03-17
1912178088 Crystal S Fifer Case Manager/Care Coordinator 1804 Highway 45 Byp, Suite 604, Jackson, TN 38305-4436 2008-03-17
1194996264 Brian K Billings Social Worker 1804 Highway 45 Byp, Suite 604, Jackson, TN 38305-4436 2008-03-17
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1427656818 Kimaya Jelks Specialist 1869 45 Hwy Bypass, Suite 2b, Jackson, TN 38305 2020-10-16
1821600578 Maame Obeng Pharmacist 3144 North Highland Avenue, Jackson, TN 38305 2020-08-22
1700361904 James Cowie Psychologist 156c West University Pkwy, Jackson, TN 38305 2018-10-03
1700372109 Chad Zawacki Physician Assistant 147 North Star Drive, Jackson, TN 38305 2018-07-09
1104323070 Golden Years Adult Day Care Clinic/Center 155 Carriage Dr Suite A, Jackson, TN 38305 2018-04-09
1245754563 Tanika Annette Gillard Massage Therapist 4 Hampton Ln, Jackson, TN 38305 2017-07-28
1316488117 Lakisha T Ingram Counselor 168 Greencastle Dr, Jackson, TN 38305 2017-03-13
1619421567 D & L Wellness Inc Community/Behavioral Health 154 Carriage House Dr., Jackson, TN 38305 2016-08-09
1649637638 Advance Choice Home Care LLC In Home Supportive Care 1028 Ashport Rd., Jackson, TN 38305 2016-01-21
1942666151 Neurohealth Solutions Inc. Clinic/Center 174 Murray Guard Dr. Suite E, Jackson, TN 38305 2016-01-05
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Taxonomy Information

Taxonomy Code 171M00000X
Grouping Other Service Providers
Classification Case Manager/Care Coordinator

Taxonomy Definition

A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management.
Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1023644135 Leslie Sue Krantz Case Manager/Care Coordinator 8431 Oakpoint Dr, Jackson, MI 49201-9229 2020-03-20
1669008405 Alt Best Practices Bhom2, LLC Case Manager/Care Coordinator 81 Crooked Stick Rd, Jackson, NJ 08527-4032 2020-03-12
1568009637 Katherine Pringle Ford Case Manager/Care Coordinator 2065 E. Limber Pine Road, Jackson, WY 83001 2019-12-07
1336601459 Richard Daniel Bryant Case Manager/Care Coordinator 950 W Monroe St Ste 600a, Jackson, MI 49202-2079 2019-04-05
1013478643 Makeshia Warden Case Manager/Care Coordinator 655 Pine Ln, Jackson, MS 39212-3563 2019-03-27
1053893792 Allison Brynne Liljestrom Case Manager/Care Coordinator 355 Arapahoe Ln, Jackson, WY 83001-8607 2018-08-29
1033691845 Debra Ann Hathcock Case Manager/Care Coordinator 724 W Snow King Ave # 7825, Jackson, WY 83001-8498 2018-08-29
1053809053 Natasha W Tyler Case Manager/Care Coordinator 5615 Brentwood Dr, Jackson, MS 39211-4233 2018-04-25
1245690924 Darlene Bell Case Manager/Care Coordinator 546 Clydes Way, Jackson, GA 30233-1891 2016-02-24
1598134256 Theodore Weber Shoaf Case Manager/Care Coordinator 3405 S Winding Trail Dr, Jackson, WY 83001-9257 2015-09-23
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Competitor

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City JACKSON
Zip Code 38305

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Dataset Information

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.

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