Jack C Moore Ii (NPI# 1164443529, PAC ID# 3173599404) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1164443529 |
| PAC ID by PECOS | 3173599404 |
| Professional Enrollment ID | I20040908000351 |
| Full Name | Jack C Moore Ii |
| Organization Legal Name | KOMG-LOUISVILLE REGION INC |
| Address |
515 Hospital Dr Suite 1 Shelbyville KY 40065-1619 |
| Phone Number | 5026333525 |
| Gender | M |
| Credential | MD |
| Medical School | WEST VIRGINIA UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 1987 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 5799021259 |
| Number of Group Practice Members | 293 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 180040 | JEWISH HOSPITAL & ST MARY'S HEALTHCARE |
| 180088 | NORTON HOSPITALS, INC |
| Address | Phone | Organization |
|---|---|---|
| 515 Hospital Dr, Suite 1, Shelbyville, KY 40065-1619 | 5026333525 | KOMG-LOUISVILLE REGION INC |
| Organization Legal Name | KOMG-LOUISVILLE REGION INC |
| Physicians | 228 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kathleen Troutman | Nurse Practitioner | Komg-louisville Region Inc | 908 Dupont Rd, Louisville, KY 40207-4602 |
| Jamie L Greenert | Nurse Practitioner | Komg-louisville Region Inc | 4423 Bardstown Rd, Louisville, KY 40218-3235 |
| Crystal N Weathers | Nurse Practitioner | Komg-louisville Region Inc | 8111 Bardstown Rd, Louisville, KY 40291-3441 |
| Lindsey Winfield | Nurse Practitioner | Komg-louisville Region Inc | 1607 Dixie Hwy, Louisville, KY 40210-1745 |
| Melissa R Lamaster | Nurse Practitioner | Komg-louisville Region Inc | 9569 Taylorsville Rd, Suite 109, Louisville, KY 40299-2751 |
| Ivan A Calderon | Family Medicine | Komg-louisville Region Inc | 5100 Outer Loop, Louisville, KY 40219-3023 |
| Sara A Miller | Nurse Practitioner | Komg-louisville Region Inc | 1900 Bluegrass Ave, Suite 300, Louisville, KY 40215-1183 |
| Christopher D Combs | Internal Medicine | Komg-louisville Region Inc | 175 S English Station Rd, Suite 226, Louisville, KY 40245-4199 |
| Christopher John Theuer | General Surgery | Komg-louisville Region Inc | 60 Stonecrest Ct, Suite 140, Shelbyville, KY 40065-8156 |
| John N Olsofka | General Surgery | Komg-louisville Region Inc | 4402 Churchman Ave, Louisville, KY 40215-1190 |
| Street Address |
515 HOSPITAL DR SUITE 1 |
| City | SHELBYVILLE |
| State | KY |
| Zip | 40065-1619 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sherman L Armstrong | General Surgery | Ivy Creek of Elmore LLC | 515 Hospital Dr, Wetumpka, AL 36092-1626 |
| David Maddox | Internal Medicine | Komg-louisville Region Inc | 515 Hospital Dr, Suite 1, Shelbyville, KY 40065-1619 |
| David W Wallace | Family Medicine | Komg-louisville Region Inc | 515 Hospital Dr, Suite 1, Shelbyville, KY 40065-1619 |
| James R Smith | Family Medicine | Komg-louisville Region Inc | 515 Hospital Dr, Suite 1, Shelbyville, KY 40065-1619 |
| Edward L Sames | Internal Medicine | Komg-louisville Region Inc | 515 Hospital Dr, Suite 1, Shelbyville, KY 40065-1619 |
| Amy M Morehead | Nurse Practitioner | Komg-louisville Region Inc | 515 Hospital Dr, Suite 1, Shelbyville, KY 40065-1619 |
| Brian E Richardson | Urology | Jackson Hospital and Clinic, Inc. | 515 Hospital Dr, Suite A, Wetumpka, AL 36092-1626 |
| Anna E Barrickman | Nurse Practitioner | Komg-louisville Region Inc | 515 Hospital Dr, Suite 1, Shelbyville, KY 40065-1619 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Daniel M Bowersox | Optometry | Bowersox Vision Center, Psc | 403 Washington St, Shelbyville, KY 40065-1127 |
| Stuart Boyd Young | Optometry | Bowersox Vision Center, Psc | 403 Washington St, Shelbyville, KY 40065-1127 |
| Lauren M Mckinch | Optometry | Bowersox Vision Center, Psc | 403 Washington St, Shelbyville, KY 40065-1127 |
| Kenneth R Gravett | Family Medicine | 517 Washington St, Shelbyville, KY 40065-1129 | |
| Julie J Guyton | Clinical Social Worker | Whitten Psychological Services Pllc | 1028 Main St, Shelbyville, KY 40065-1315 |
| Curtis D Chandler | Psychologist, Clinical | Whitten Psychological Services Pllc | 1028 Main St, Shelbyville, KY 40065-1315 |
| Thomas E Hedden | Clinical Social Worker | Whitten Psychological Services Pllc | 1028 Main St, Shelbyville, KY 40065-1315 |
| Michael E Whitten | Psychologist, Clinical | Whitten Psychological Services Pllc | 1028 Main St, Shelbyville, KY 40065-1315 |
| Shaleesha Nyree-zeni Coleman | Physical Therapy | Agilitas Usa Inc | 1621 Midland Trl, Shelbyville, KY 40065-1638 |
| Sara L Pourheydarian | Optometry | Louisville Optometric Centers IIi, Psc | 1627 Midland Trl, Shelbyville, KY 40065-1638 |
| Find all physicians in zip 40065 | |||
| City | SHELBYVILLE |
| Zip Code | 40065 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | SHELBYVILLE + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Jack C Moore Ii.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.