JACOB MOORE


Address: 1900 Silver Lake Rd Nw, Suite 110, New Brighton, MN 55112-1786
Phone: 6516289566

JACOB MOORE (NPI# 1851780928) 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) 1851780928
Entity Type Individual
Full Name JACOB MOORE
Credential PA-C
Practice Address 1900 Silver Lake Rd Nw
Suite 110
New Brighton
MN 55112-1786
Practice Telephone 6516289566
Practice Fax Number 6516280411
Mailing Telephone 6516289566
Mailing Fax Number 6516280411
Enumeration Date 2015-01-13
Last Update Date 2015-04-27
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363A00000X Physician Assistant MN Physician Assistants & Advanced Practice Nursing Providers

Other Providers JACOB MOORE

NPI Name Taxonomy Address Enumeration
1154617058 Jacob E Moore Emergency Medicine 2326 N Lincoln Park W Apt 4b, Chicago, IL 60614-3446 2011-06-20
1043459175 Jacob B Moore Physical Medicine & Rehabilitation 2707 Stange Road Suite 102, Mcfarland Clinic PC, Ames, IA 50010-3014 2009-02-12
1144249277 Jacob Jackson Moore Ophthalmology 900 Morgan Ave, Corpus Christi, TX 78404-2028 2006-07-19
1831719947 Jacob Ryan Moore Student in an Organized Health Care Education/Training Program 2100 Stantonsburg Rd, Greenville, NC 27834-2818 2020-04-17
1497384424 Jacob Aaron Moore Nurse Practitioner 800 Rose St, Lexington, KY 40536-7001 2020-04-02
1255892287 Jacob James Moore Psychiatry & Neurology 155 N Fresno St, Fresno, CA 93701-2302 2019-03-31
1336644723 Jacob Clark Moore Student in an Organized Health Care Education/Training Program 250 Park St, Bowling Green, KY 42101-1760 2018-03-27
1821512179 Jacob Moore Specialist/Technologist 116 Ward Sports Medicine Building, Greenville, NC 27858 2017-07-28
1588027007 Jacob Moore Pharmacist 1745 Quentin Rd, Lebanon, PA 17042-7435 2016-04-01
1750762928 Jacob Robert Moore Emergency Medicine 5841 S Maryland Ave Rm L539, Chicago, IL 60637-1447 2015-06-14

Office Location

Street Address 1900 SILVER LAKE RD NW
SUITE 110
City NEW BRIGHTON
State MN
Zip Code 55112-1786

Providers in the same location

NPI Name Taxonomy Address Enumeration
1861492134 Edwin Walker Psychiatry & Neurology 1900 Silver Lake Rd Nw, New Brighton, MN 55112-1786 2005-07-28
1144833484 Anna Marie Ricci Counselor 1900 Silver Lake Rd Nw, New Brighton, MN 55112-1786 2020-08-26
1568086346 Kenneth Leroy King Sr. Student in an Organized Health Care Education/Training Program 1900 Silver Lake Rd Nw, New Brighton, MN 55112-1786 2020-06-08
1184247108 Alissa Marie Lambrides Counselor 1900 Silver Lake Rd Nw, New Brighton, MN 55112-1786 2020-05-26
1184247660 Tammie Leetta Fullman Counselor 1900 Silver Lake Rd Nw, New Brighton, MN 55112-1786 2020-05-19
1396379541 Meredith Lawlor Counselor 1900 Silver Lake Rd Nw, New Brighton, MN 55112-1786 2020-02-26
1154961225 Ryan Jones Counselor 1900 Silver Lake Rd Nw, New Brighton, MN 55112-1786 2020-01-07
1902440944 Olufemi Michael Adetunji Nurse Practitioner 1900 Silver Lake Rd Nw, New Brighton, MN 55112-1786 2019-11-02
1174166672 Williametta Augusta Wells Counselor 1900 Silver Lake Rd Nw, New Brighton, MN 55112-1786 2019-10-28
1780227736 Jason T Caspillo Psychologist 1900 Silver Lake Rd Nw, New Brighton, MN 55112-1786 2019-10-22
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1932729704 Owegio Wreh Technician 1405 Silver Lake Road Suite 15, New Brighton, MN 55112 2020-04-22
1205497435 Silver Lake Smiles Family Dentistry Clinic/Center 2370 Palmer Drive, New Brighton, MN 55112 2019-06-27
1932766169 Matthew Thomas Hanowski Dentist 2442 Mounds View Boulevard, Mounds View, MN 55112 2019-05-22
1437619988 Marjean Diane Leary Registered Nurse 338 New Brighton Road, Apt, Suite, Bldg. (optional), New Brighton, MN 55112 2019-03-21
1558802728 Krishna Katira Student in an Organized Health Care Education/Training Program 2442 County Hwy 10, Mounds View, MN 55112 2017-03-20
1245781608 Evan Fredrick Lieberman Counselor 1900 Silver Lake Rd, Suite 110, New Brighton, MN 55112 2016-10-20
1093262065 Ryan Zinken Nurse Practitioner 1900 Silver Lake Road, Suite 110, New Brighton, MN 55112 2016-09-07
1447703228 Alison Glodek Social Worker 2543 17th St Nw, New Brighton, MN 55112 2016-07-28
1659728194 Ge Vang Sr. Driver 2160 County Road E West #205, 2160 County Road E West #205, New Brighton, MN 55112 2016-05-14
1114373578 Jessica Gapinski Specialist/Technologist 3900 Bethel Drive, Arden Hills, MN 55112 2016-05-04
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Taxonomy Information

Taxonomy Code 363A00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant

Taxonomy Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1033673058 Amanda Drewek Physician Assistant 1900 Silver Lake Rd Nw Ste 110, New Brighton, MN 55112-1789 2019-01-23
1255889689 Polly Hendel Physician Assistant 1900 Silver Lake Rd Nw Ste 110, New Brighton, MN 55112-1789 2016-09-14
1982093449 Annette Lerew-zimanski Physician Assistant 1900 Silver Lake Rd Nw, New Brighton, MN 55112-1786 2015-01-21
1790086411 Laura K Stanz Physician Assistant 1151 Silver Lake Rd Nw, New Brighton, MN 55112-6324 2010-11-11
1457688244 Jaclyn Schloesser Physician Assistant 1900 Silver Lake Rd Nw, Suite 110, New Brighton, MN 55112-1786 2009-11-16
1043419450 Lindsey K Locken Physician Assistant 1151 Silver Lake Rd Nw, New Brighton, MN 55112-6324 2007-07-16
1194743203 Sarah Mae Anikpo Physician Assistant 1900 Silver Lake Rd Nw, Suite 110, New Brighton, MN 55112-1786 2006-07-17
1356375679 Veronica Lee Valencourt Physician Assistant 1900 Silver Lake Rd Nw, Suite 110, New Brighton, MN 55112-1786 2006-07-10

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1588265284 Foua Vang Physician Assistant 689 County Road D E Apt 302, Saint Paul, MN 55117-1263 2020-11-08
1043811870 Leiah Hoffman Physician Assistant 4243 Timberridge Ln Apt A, Hermantown, MN 55811-4047 2020-11-06
1760083059 Amanda Hanover Physician Assistant 10346 Mississippi Blvd Nw, Coon Rapids, MN 55433-4521 2020-11-04
1780284844 Lily Ganz Physician Assistant 2737 Huntington Ave, St Louis Park, MN 55416-3917 2020-10-28
1972103000 Jaclyn Ann Bautch Physician Assistant 24721 State Highway 15, Saint Augusta, MN 56301-9211 2020-10-28
1801496047 Tanner Vaughn Kramp Physician Assistant 3450 Wild Turkey Rd, Red Wing, MN 55066-1762 2020-10-27
1497354955 Sarah Marti Physician Assistant 810 Thornton St Se Apt 904, Minneapolis, MN 55414-3652 2020-10-25
1598364473 Kylee N Persing Physician Assistant 10 4th Ave S, Saint Cloud, MN 56301-3614 2020-10-21
1073112009 Reece Edward Mcevoy Physician Assistant 2638 Sand Trap Rd Se, Rochester, MN 55904-3904 2020-10-21
1679189021 Anne Elizabeth Drabot Physician Assistant 4741 Vincent Ave S, Minneapolis, MN 55410-1843 2020-09-21
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Competitor

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City NEW BRIGHTON
Zip Code 55112

Improve Information

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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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