Jeffrey Ryan Moore

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

0101254499 Issued in VA

Practice address

620 John Paul Jones Cir
Portsmouth, VA 23708-2111

Phone

(757) 953-3149

NPI assigned

Feb 9, 2012

Sex

Male

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

Enrolled in ID

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

Specialty

Internal Medicine

Education

East Tennessee State University Quillen College of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

St Lukes Clinic-Treasure Valley LLCGroup PAC ID 4981878402, 1,155 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• First Choice Home Care Home health agency, Boise, ID, CCN 137108
• St Lukes Home Care and Hospice Home health agency, Meridian, ID, CCN 137028
• Horizon Home Health Home health agency, Meridian, ID, CCN 137065
• Bluebird Home Health Home health agency, Meridian, ID, CCN 137049
• St Luke'S Regional Medical Center Hospital, Boise, ID, CCN 130006
• St Luke'S Nampa Medical Center Hospital, Nampa, ID, CCN 130071

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jmoore153477@direct.slhs.org

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.

• St Lukes Clinic-Treasure Valley LLC

  • Family Medicine Physician
  • Boise, ID
  • NPI 1326336058

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• St Lukes Regional Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1770586794
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bluebird Home Health, LLC

  • Home Health Agency
  • Meridian, ID
  • NPI 1861082588
  Care Compare affiliation
• First Choice Home Care, Inc.

  • Home Health Agency
  • Boise, ID
  • NPI 1952305286
  Care Compare affiliation
• St Luke'S Regional Medical Center

  • Home Health Agency
  • Meridian, ID
  • NPI 1306945985
  Care Compare affiliation
• St Lukes Regional Medical Center

  • Ambulance
  • Boise, ID
  • NPI 1518115195

  Hospital

  Care Compare affiliation
• St Lukes Regional Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1770586794
  Care Compare affiliation
• St Lukes West LTD

  • General Acute Care Hospital
  • Nampa, ID
  • NPI 1831590660
  Care Compare affiliation
• Teton Healthcare, Inc.

  • Home Health Agency
  • Meridian, ID
  • NPI 1689996357
  Care Compare affiliation

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

{
    "created_epoch": "1328745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460764800000",
    "number": "1285907055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NAVAL HOSPITAL TWENTYNINE PALMS",
            "address_2": "1145 STURGIS RD",
            "city": "TWENTYNINE PALMS",
            "state": "CA",
            "postal_code": "92278",
            "telephone_number": "760-830-2082",
            "fax_number": "760-830-5264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 JOHN PAUL JONES CIR",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237082111",
            "telephone_number": "757-953-3149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JEFFREY",
        "middle_name": "RYAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-02-09",
        "last_updated": "2016-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101254499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amia Moore
• Dorothy M Moore, PH.D., LPC, ACS
• Edna E. Moore, MSN, WHNP
• Evan Moore, MD
• Jeffrey Lee Moore Jr., D.O.
• John Blaine Moore, M.D.
• Latasha D Moore
• Natalya E Moore
• Sarah F Moore, MD
• Kenesha Moorehead

• Internal Medicine Physician in Portsmouth, VA
• Providers in Portsmouth, VA by specialty
• Internal Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.