Jerica Moore, MA, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2009 Issued in TN

Practice address

1041 Hamiltion Place Dr.
Johnson City, TN 37604

Phone

(423) 707-2509

NPI assigned

May 23, 2018

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Foundation Health Services, PLLC

  dba Foundation Health

  • Urgent Care Clinic/Center
  • Gray, TN
  • NPI 1376922278
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1527033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527033600000",
    "number": "1174014450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 HIGHLAND AVE APT B",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046847",
            "telephone_number": "863-381-8342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1041 HAMILTION PLACE DR.",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "37604",
            "telephone_number": "423-707-2509"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3314 Wayfield Dr Ste 3",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376011907",
            "country_code": "US",
            "telephone_number": "863-381-8342",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JERICA",
        "credential": "MA, ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-23",
        "last_updated": "2018-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TN",
            "license": "2009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mooney's Pharmacy, Inc. (Mooney's Home Medical Equipment)
• Betheny Moore
• Brad Edward Moore, NP
• Brandon K Moore, DO
• Corrinne Elizabeth Moore
• Jessica Moore, RN
• Jessica Rivers Moore
• Jordan Elizabeth Moore
• Melvin Gregory Moore, D.D.S.
• Sean Anthony Moore, MD

• Athletic Trainer in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Athletic Trainer in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.