Individual provider Active NPI

Jessica Moore, M.D.

  • Pediatrics Physician
  • Friendswood, TX
National Provider Identifier
1598080970
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
R3384 Issued in TX
Practice address
1506 E Winding Way Dr Ste 604
Friendswood, TX 77546-5391
Phone
(832) 569-2183
Fax
(832) 569-2171
NPI assigned
Mar 29, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X E-7945 AR
Pediatrics Physician 208000000X R3384 TX Primary

Addresses

Primary practice location

1506 E Winding Way Dr Ste 604
Friendswood, TX 77546-5391

Mailing address

2407 Pine Dr
Friendswood, TX 77546-5542
Phone (832) 569-2183

Other practice location 1

1 Childrens Way
Slot 512-9
Little Rock, AR 72202-3500
Phone (501) 364-5358

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
R3384TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eating Recovery Center of Texas PastSince Dec 1, 2022 Accepting new patients
Pediatric Urgent Care PA Pediatrics Past Accepting new patients
Goodside Health Medical, PLLC Pediatrics Past Accepting new patients
Goodside Health Medical, PLLC Pediatrics Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1269820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1598080970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2407 PINE DR",
            "city": "FRIENDSWOOD",
            "state": "TX",
            "postal_code": "775465542",
            "telephone_number": "832-569-2183",
            "fax_number": "832-569-2171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1506 E WINDING WAY DR STE 604",
            "city": "FRIENDSWOOD",
            "state": "TX",
            "postal_code": "775465391",
            "telephone_number": "832-569-2183",
            "fax_number": "832-569-2171"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Childrens Way",
            "address_2": "Slot 512-9",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722023500",
            "country_code": "US",
            "telephone_number": "501-364-5358",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JESSICA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-29",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AR",
            "license": "E-7945",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "R3384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Friendswood, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 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.

Verify at the official NPI Registry.