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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
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 |
Street Address |
1804 HIGHWAY 45 BYP SUITE 604 |
City | JACKSON |
State | TN |
Zip Code | 38305-4436 |
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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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 |
Find all providers in zip 38305 |
Taxonomy Code | 171M00000X |
Grouping | Other Service Providers |
Classification | Case Manager/Care Coordinator |
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] |
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 |
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.