Jerri Dawn Moore

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

130829 Issued in OH

Practice address

14572 US Highway 23 Ste a
Waverly, OH 45690-9448

Phone

(740) 947-6727

NPI assigned

Feb 13, 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

State licenses

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

{
    "created_epoch": "1518480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518480000000",
    "number": "1295235679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 CARROLL ST",
            "city": "WAVERLY",
            "state": "OH",
            "postal_code": "456901202",
            "telephone_number": "740-947-6727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14572 US HIGHWAY 23 STE A",
            "city": "WAVERLY",
            "state": "OH",
            "postal_code": "456909448",
            "telephone_number": "740-947-6727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JERRI",
        "middle_name": "DAWN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-13",
        "last_updated": "2018-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "130829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory G Montavon, O.D
• April Dawn Montgomery, LPN
• Jennifer Sue Montgomery, CT
• Courtney Elaine Moore, NP
• Jenna Moore
• Roger Moore
• Sarah Moore
• Tesa Moore, PTA
• Stacy Davis Moorman, DDS
• Christy Moraleja

• Addiction (Substance Use Disorder) Counselor in Waverly, OH
• Providers in Waverly, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 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.