Active NPI
Jackie Coombe-Moore, M.D.
- Psychiatry Physician
- Morrilton, AR
National Provider Identifier
1154489581
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- C8291
- Practice address
- Counseling Associates, Inc
8 Hospital Drive
Morrilton, AR 72110 - Phone
- (501) 505-8900
- Fax
- (501) 505-8902
- NPI assigned
- Dec 5, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | C8291 | AR | Primary |
Addresses
Primary practice location
Counseling Associates, Inc
8 Hospital Drive
Morrilton, AR 72110
Mailing address
34 Masters Place Drive
Maumelle, AR 72113
Phone (501) 505-8900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 122013001 | Medicaid | AR |
Other names 1
- Jackie Moore
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C8291 | AR | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560470400000",
"number": "1154489581",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34 MASTERS PLACE DRIVE",
"city": "MAUMELLE",
"state": "AR",
"postal_code": "72113",
"telephone_number": "501-505-8900",
"fax_number": "501-505-8902"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "COUNSELING ASSOCIATES, INC",
"address_2": "8 HOSPITAL DRIVE",
"city": "MORRILTON",
"state": "AR",
"postal_code": "72110",
"telephone_number": "501-505-8900",
"fax_number": "501-505-8902"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOMBE-MOORE",
"first_name": "JACKIE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-05",
"last_updated": "2019-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "AR",
"license": "C8291",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "122013001",
"state": "AR"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JACKIE",
"last_name": "MOORE",
"credential": "M.D.",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Morrilton, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.