James Eddie Moore, CADC-III

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

2041 Issued in WI

Practice address

2319 W Capitol Dr
Milwaukee, WI 53206-1919

Phone

(414) 744-5370

Fax

(414) 744-9052

NPI assigned

Jan 30, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Gateway to Change

  • Community/Behavioral Health Agency
  • Milwaukee, WI
  • NPI 1023281987
  NPD (past)

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426464000000",
    "number": "1427194877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5707 W AUER AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532163135",
            "telephone_number": "414-444-3883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2319 W CAPITOL DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532061919",
            "telephone_number": "414-744-5370",
            "fax_number": "414-744-9052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JAMES",
        "middle_name": "EDDIE",
        "name_prefix": "Mr.",
        "credential": "CADC-III",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2015-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "2041",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39369400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anthony Moore
• Arthur G Moore, MD
• Christina C Moore, M.D.
• Claire Louise Moore, PTA, CMT
• Crystal Moore
• Karmelita Moore
• Katherine D Moore, AU.D. CCC-A
• Kaylen Marua Moore, RN
• Keisha Moore
• Keyiana Moore

• Addiction (Substance Use Disorder) Counselor in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Addiction (Substance Use Disorder) Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2015; 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.