Jeremy Clint Moore, D.O.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

DO.1306 Issued in AL

Practice address

5800 Southland Dr
Mobile, AL 36693-3313

Phone

(251) 450-2211

Fax

(251) 662-7297

NPI assigned

May 6, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Altapointe Health Systems, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mobile, AL
  • NPI 1518095413
  Medicare reassignment NPD
• Altapointe Health Systems Inc

  • Psychiatric Hospital
  • Daphne, AL
  • NPI 1093010936
  NPD
• Altapointe Health Systems, Inc.

  • Federally Qualified Health Center (FQHC)
  • Foley, AL
  • NPI 1003707332
  NPD
• Altapointe Health Systems, Inc.

  • Federally Qualified Health Center (FQHC)
  • Mobile, AL
  • NPI 1851050314
  NPD (past)

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

{
    "created_epoch": "1304640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662940800000",
    "number": "1205128451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5750A SOUTHLAND DR",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366933316",
            "telephone_number": "251-450-5916",
            "fax_number": "251-662-7297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5800 SOUTHLAND DR",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366933313",
            "telephone_number": "251-450-2211",
            "fax_number": "251-662-7297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JEREMY",
        "middle_name": "CLINT",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-06",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AL",
            "license": "DO.1306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Moore
• Emily Collins Moore, CRNP
• Gwendolyn Moore, MPH, RN, CHC
• Hunter Thomas Moore
• Jacob Brooks Moore, PA-C
• Jonathan Ross Moore Sr., M.D.
• Jordan William Moore, DC
• Joshua L Moore, LPC, NCC
• Katherine Rosman Moore, DPT
• Kenetha Moore, RN

• Psychiatry Physician in Mobile, AL
• Providers in Mobile, AL by specialty
• Psychiatry Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.