J David Moore, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

35169 Issued in SC

Practice address

23 Buena Vista Way, Ste B
Greenville, SC 29615

Phone

(864) 315-3736

Fax

(864) 315-3736

NPI assigned

Aug 13, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Aug 1, 2017 through Aug 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612051200000",
    "number": "1497767792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1491 ALTAMONT RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296096211",
            "telephone_number": "864-546-8284",
            "fax_number": "864-315-3736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 BUENA VISTA WAY, STE B",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "29615",
            "telephone_number": "864-315-3736",
            "fax_number": "864-315-3736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "J",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-13",
        "last_updated": "2021-01-31",
        "certification_date": "2021-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "040166",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SC",
            "license": "35169",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "351693",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Claudia Moore
• Dannah Michele Moore, MSN, RN, PMHNP-BC
• Deana Moore, RBT
• Denise A Moore, CRNA
• Garrison Hunter Moore, M.D.
• James Lee Moore, DMD
• Janice Lynn Moore, MSC CCCSLP
• John Davis Moore, M.D.
• Justin Claude Moore, NURSE PRACTITIONER
• Keshia Latonya Moore, COTA

• Psychiatry Physician in Greenville, SC
• Providers in Greenville, SC by specialty
• Psychiatry Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.