Jacob Clark Moore, DO

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

02006369A Issued in IN

Practice address

600 Mary St
Evansville, IN 47747-0001

Phone

(812) 450-3036

Fax

(812) 450-2193

NPI assigned

Mar 27, 2018

Last updated

Jul 1, 2021By the provider in NPPES

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

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Hospitalist

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Commonwealth Health Corporation, Inc.Group PAC ID 5496667628, 268 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• The Medical Center (Bowling Green) Hospital, Bowling Green, KY, CCN 180013

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Commonwealth Health Corporation, Inc

  dba Med Center Health Neurology

  • Neurology Physician
  • Bowling Green, KY
  • NPI 1881109304
  Medicare reassignment Care Compare group NPD
• Deaconess Hospital Inc

  • Mental Health Counselor
  • Evansville, IN
  • NPI 1508723552
  NPD
• Deaconess Hospital, Inc

  dba Deaconess Care Group

  • Hospitalist Physician
  • Evansville, IN
  • NPI 1427097443
  NPD
• Commonwealth Health Corporation, Inc.

  dba Med Center Health Plastic & Reconstructive Surgery

  • Plastic and Reconstructive Surgery Physician
  • Bowling Green, KY
  • NPI 1104470699
  NPD
• Commonwealth Health Corporation, Inc.

  dba Med Center Health Western Kentucky Heart & Lung

  • Interventional Cardiology Physician
  • Bowling Green, KY
  • NPI 1194562579
  NPD
• Bowling Green-Warren County Community Hospital Corporation

  dba The Medical Center

  • General Acute Care Hospital
  • Bowling Green, KY
  • NPI 1043293608
  NPD (past)

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

• Bowling Green-Warren County Community Hospital Corporation

  dba The Medical Center

  • General Acute Care Hospital
  • Bowling Green, KY
  • NPI 1043293608
  Care Compare affiliation

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

{
    "created_epoch": "1522108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625097600000",
    "number": "1336644723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3407",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477333407",
            "telephone_number": "812-450-3036",
            "fax_number": "812-450-2193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 MARY ST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477470001",
            "telephone_number": "812-450-3036",
            "fax_number": "812-450-2193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JACOB",
        "middle_name": "CLARK",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-27",
        "last_updated": "2021-07-01",
        "certification_date": "2021-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IN",
            "license": "02006369A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Byron Patrick Moore, D.D.S.
• Charleen M Moore, LCSW
• Edward N Moore, MD
• Gary Randall Moore, M.D.
• Gregory W. Moore, MD
• Jeffrey Keith Moore, MD
• Natascha Nikole Moore, MSW
• Sherri Ann Moore, PTA
• Stephanie Moore
• Tiara Moore

• Hospitalist Physician in Evansville, IN
• Providers in Evansville, IN by specialty
• Hospitalist Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2021; 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.