J. Kathleen Moore, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

J0605 Issued in TX

Practice address

809 Singleton Blvd
Dallas, TX 75212-4014

Phone

(214) 540-0300

Fax

(214) 540-0308

NPI assigned

Oct 3, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Dr. Jerri Kathleen Moore Professional name

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jmoore15708@christushealth.direct-ci.net
• Direct secure messaging: jmoore86788@direct.phs.org
• Direct secure messaging: j.moore.p1@direct.lbucc.nextgenshare.com

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.

• Appletree Pediatrics, P.a.

  • Specialist
  • Tyler, TX
  • NPI 1265613889
  NPD (past)
• Los Barrios Unidos Community Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • Dallas, TX
  • NPI 1164417085
  NPD (past)
• Tyler Family Circle of Care

  • Community/Retail Pharmacy
  • Tyler, TX
  • NPI 1942011903
  NPD (past)

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697673600000",
    "number": "1407940547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 SINGLETON BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752124014",
            "telephone_number": "214-540-0300",
            "fax_number": "214-540-0308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 SINGLETON BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752124014",
            "telephone_number": "214-540-0300",
            "fax_number": "214-540-0308"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1306 Doctors Drive",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "75701",
            "country_code": "US",
            "telephone_number": "903-592-1890",
            "fax_number": "903-592-3222",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1100 Belk Blvd",
            "address_purpose": "LOCATION",
            "city": "Oxford",
            "state": "MS",
            "postal_code": "386555242",
            "country_code": "US",
            "telephone_number": "662-636-1090",
            "fax_number": "662-636-1676",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "J. KATHLEEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2023-10-19",
        "certification_date": "2023-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MS",
            "license": "26000",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "J0605",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LIS",
            "identifier": "J0605",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JERRI",
            "last_name": "MOORE",
            "middle_name": "KATHLEEN",
            "prefix": "DR.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Dorrine B Moore, FNP C
• Elizabeth Dianne Moore, CPNP
• Erika Moore
• Hayden Moore, PT
• Howard A Moore, M.D., ASSOCIATED
• Jacey Lynn Moore, B.A., SLPA
• Jacqueline Blair Moore, LPC
• James Adam Moore, MD
• James C Moore, CRNA
• Jasmine Danae Moore

• Pediatrics Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.