Active NPI
Jennifer Moore
- Clinical Social Worker
- Indianapolis, IN
National Provider Identifier
1558129320
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 99123132A
- Practice address
- 8770 Guion Rd
Indianapolis, IN 46268-3042 - Phone
- (317) 679-5787
- NPI assigned
- Mar 7, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 99123132A | IN | Primary |
Addresses
Primary practice location
8770 Guion Rd
Indianapolis, IN 46268-3042
Mailing address
642 E 34TH St
Indianapolis, IN 46205-3764
Phone (317) 679-5787
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 99123132A | IN | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1709769600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1709769600000",
"number": "1558129320",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "642 E 34TH ST",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462053764",
"telephone_number": "317-679-5787"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8770 GUION RD",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462683042",
"telephone_number": "317-679-5787"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "JENNIFER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-03-07",
"last_updated": "2024-03-07",
"certification_date": "2024-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IN",
"license": "99123132A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.