Jermaine A Moore

Primary specialty

Ambulatory Care Registered NurseTaxonomy code 163WP2201X

License

95220734 Issued in CA

Practice address

12021 Wilmington Ave
Los Angeles, CA 90059-3019

Phone

(424) 758-9590

NPI assigned

Feb 6, 2023

Sex

Male

Sole proprietor

No

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": "1675641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675641600000",
    "number": "1316643976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1118 E 123RD ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900593206",
            "telephone_number": "424-758-9590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12021 WILMINGTON AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900593019",
            "telephone_number": "424-758-9590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JERMAINE",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-02-06",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP2201X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "CA",
            "license": "95220734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jasmine Moore, M.S
• Jason Moore
• Jenery Aguilera Moore
• Jennifer Moore, MSW, LCSW
• Jeremy Paul Moore, M.D.
• Jessica Moore
• Jonathan Moore, DPT
• Jonathan J Moore
• Jordana Moore
• Joseph William Moore, RN

• Ambulatory Care Registered Nurse in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Ambulatory Care Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2023; 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.