MR. DERRICK MICHAEL MOORE (NPI# 1902950736) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902950736 |
| Entity Type | Individual |
| Full Name | MR. DERRICK MICHAEL MOORE |
| Credential | LMSW |
| Practice Address |
1500 E. Woodrow Wilson Dr. Jackson MS 39216-5199 |
| Mailing Address |
5354 Keele St Jackson MS 39206-4106 |
| Practice Telephone | 6013624471 |
| Practice Fax Number | 6013684093 |
| Mailing Telephone | 6014542080 |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 104100000X | Social Worker | M6782 | MS | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114399128 | Derrick Moore | Counselor | 631 N 10th St, Philadelphia, PA 19123-2601 | 2015-10-29 |
| 1770739872 | Derrick Monterey Moore Sr. | Driver | 8325 Poplar Springs Dr Lot 55, Meridian, MS 39305-9243 | 2008-08-08 |
| 1396384798 | Derrick Moore | Case Manager/Care Coordinator | 1910 Fairgrove Ave, Hamilton, OH 45011-1930 | 2020-01-02 |
| 1598738098 | Derrick Moore | Internal Medicine | 1155 Mill St, Reno, NV 89502-1576 | 2006-02-07 |
| Street Address |
1500 E. WOODROW WILSON DR. |
| City | JACKSON |
| State | MS |
| Zip Code | 39216-5199 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639195878 | Bonnie D Bower | Nurse Practitioner | 1500 E. Woodrow Wilson Dr., Jackson, MS 39216-5199 | 2006-07-14 |
| 1043302003 | Paul Bernard Matens | Social Worker | 1500 E. Woodrow Wilson Dr., Department of Veterans Affairs Medical Center (586/122, Jackson, MS 39216-5591 | 2006-09-28 |
| 1518063775 | Rebecca Kay Brewster | Nurse Practitioner | 1500 E. Woodrow Wilson Dr., Jackson, MS 39216-5199 | 2006-09-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861011553 | Ashley Melancon Prewitt | Registered Nurse | St. Dominic's North Campus, Behavioral Health, Jackson, MS 39216 | 2020-04-13 |
| 1194353391 | Brianna Arrington | Student in an Organized Health Care Education/Training Program | Med/ Peds, 2500 N. State St., Jackson, MS 39216 | 2020-04-01 |
| 1720616485 | Roshina Khalid Khan | Student in an Organized Health Care Education/Training Program | Department of Anesthesiology, Ummc, 2500 N. State St., Jackson, MS 39216 | 2020-03-30 |
| 1275183550 | Amanda Lynn Morellato | Dentist | Ummc School of Dentistry, 2500 North State Street, Jackson, MS 39216 | 2019-09-18 |
| 1396305553 | Abhishek Chhabra | Student in an Organized Health Care Education/Training Program | Lakeland Family Medicine Clinic, 878 Lakeland Dr., Jackson, MS 39216 | 2019-06-19 |
| 1427615996 | Hometown Diagnostics | Clinical Medical Laboratory | Translational Research Center Tr311, 2500 North State Street, Jackson, MS 39216 | 2019-05-21 |
| 1346807773 | Shukundala C Smith | Behavior Technician | New Learning Resources 2510 Lakeland Terrace, Jackson, MS 39216 | 2019-05-21 |
| 1063901098 | G Eli Howell Md Pllc | Plastic Surgery | 971 Lakeland Dr Ste 225, Jackson, MS 39216 | 2018-05-04 |
| 1588168132 | Caleb Zumbro | Student in an Organized Health Care Education/Training Program | Ummc Med/peds, 2500 N. State St., Jackson, MS 39216 | 2018-03-20 |
| 1639677230 | Walgreen Co | Pharmacy | 971 Lakeland Dr Ste 101, Jackson, MS 39216 | 2018-01-29 |
| Find all providers in zip 39216 | ||||
| Taxonomy Code | 104100000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public. |
| Notes: Source: National Association of Social Workers, 2009 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750989612 | Rhonda Bufkin | Social Worker | 405 Briarwood Dr Ste 302, Jackson, MS 39206-3052 | 2020-10-13 |
| 1023645884 | Cycle of Life Support Community Health Services LLC | Social Worker | 1520 E Ganson St, Jackson, MI 49202-3530 | 2020-03-23 |
| 1669006532 | Alexis Holly | Social Worker | 405 Briarwood Dr # 302, Jackson, MS 39206-3052 | 2020-02-28 |
| 1609418250 | Ashley Frascella | Social Worker | 13 Parkhill St, Jackson, NJ 08527-3737 | 2019-10-16 |
| 1104475268 | Valerie Baker | Social Worker | 172 W University Pkwy Ste A, Jackson, TN 38305-1622 | 2019-09-10 |
| 1548815863 | Lily Kovach | Social Worker | 6552 Smith Rd, Jackson, MI 49201-9612 | 2019-08-04 |
| 1285298513 | Kyla Milan Washington | Social Worker | 950 W Monroe St Ste 600a&b, Jackson, MI 49202-2079 | 2019-04-22 |
| 1639630551 | Pamela Stalter-o'neil | Social Worker | 5572 Viking Dr, Jackson, MI 49201-8815 | 2019-03-26 |
| 1407316284 | Yvonne Vieira Moffett | Social Worker | 950 W Monroe St Ste A&600b, Jackson, MI 49202-2079 | 2019-03-20 |
| 1710458419 | Jasmine Grace Walker | Social Worker | 338 Galvez St, Jackson, MS 39209-3903 | 2018-12-06 |
| 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.