Jodi Moore, PA-C
Individual provider Active NPI Physician Assistant · Dickinson, ND
NPI 1366412843 · NPPES record last updated Jul 13, 2026
Key facts
- NPI
- 1366412843
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PAC0303 (ND)
- Practice address
- 47 8TH St W
Dickinson, ND 58601-3951 - Phone
- (701) 456-3819
- Fax
- (701) 456-3815
- NPI assigned
- Jan 25, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 10
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- University of North Dakota School of Medicine, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- West River Health Services
Practice addresses (Care Compare)
401 Millionaire Ave
Mott, ND 58646-7270
Phone (701) 567-4561
Hospital & facility affiliations
- West River Regional Medical Center
- Sanford Medical Center Bismarck
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ND
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040426000225 | ND | Practitioner - Physician Assistant | 7810983632 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PAC0303 | ND | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| West River Health Services | Current |
Accepting new patients | |
| West River Health Services | Current |
Accepting new patients | |
| West River Health Services | Current |
Accepting new patients |
Locations
1000 Highway 12
Hettinger, ND 58639
Phone (701) 567-4561
401 Millionaire Ave
Ste B
Mott, ND 58646
Phone (701) 824-2391
Interoperability endpoints
- jodimoore@wrhs.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PAC0303 | ND | Yes |
Addresses
Primary practice location
47 8TH St W
Dickinson, ND 58601-3951
Mailing address
47 8TH St W
Dickinson, ND 58601-3951
Phone (701) 456-3819
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00074851 | Other | ND | RAILROAD MEDICARE |
Other providers in Dickinson, ND
- Wendy G Moffett
- Sarah K Monke
- Rachel L. Monroe
- Benjamin Montgomery
- Jennifer Moore
- Charla Rae Morin
- Chelsey Morlock
- Brooke Victoria Morris
- Awna Marie Mortenson
- Dwight R Mundy
All providers in Dickinson, ND · Physician Assistant in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.