Jaclyn Vaughn Moore, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

163224 Issued in KY

Practice address

234 E Gray St Ste 164
Louisville, KY 40202-1903

Phone

(502) 629-2405

NPI assigned

Sep 22, 2020

Last updated

Sep 22, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1600732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600732800000",
    "number": "1629684907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4804 DEER MEADOW LN",
            "city": "LA GRANGE",
            "state": "KY",
            "postal_code": "400316717",
            "telephone_number": "502-645-9066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 E GRAY ST STE 164",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021903",
            "telephone_number": "502-629-2405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JACLYN",
        "middle_name": "VAUGHN",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-22",
        "last_updated": "2020-09-22",
        "certification_date": "2020-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "KY",
            "license": "163224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Moore
• Gerald L Moore, M.D.
• Grace D. Moore, M.D.
• Haley Colleen Moore, COTA/L
• Jack C Moore II, MD
• Jessica Renee Moore, P.T.
• John Ferguson Moore, L.AC., DAHM
• Joshua Moore
• Kaliah Moore, RBT
• Kari Moore, APRN

• Registered Dietitian in Louisville, KY
• Providers in Louisville, KY by specialty
• Registered Dietitian in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2020; 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.