Jesse Kincaid Moore

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

4340 Borgen Blvd
Gig Harbor, WA 98332-7000

Phone

(253) 313-0704

NPI assigned

Aug 18, 2018

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

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Physician Affiliate Group of New York PC

  • Registered Dietitian
  • New York, NY
  • NPI 1013375526
  Medicare reassignment NPD

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

{
    "created_epoch": "1534550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534550400000",
    "number": "1649750613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4340 BORGEN BLVD",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983327000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4340 BORGEN BLVD",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983327000",
            "telephone_number": "253-313-0704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JESSE",
        "middle_name": "KINCAID",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-18",
        "last_updated": "2018-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cesar L Molina Sisimit, LMFTA
• Orestes Molina, MD
• Kandi Sue Moller, OD
• Margi Elizabeth Montgomery, LMP
• Zachary Tyler Mooney, DC
• Matthew Moore, D.C.
• Wayne Walter Moore, D.C.
• Andrea Kristen Morgan, MOT
• Dara Lee Morgan, ARNP
• Morris Wellness PLLC

• Speech-Language Pathologist in Gig Harbor, WA
• Providers in Gig Harbor, WA by specialty
• Speech-Language Pathologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.