Jordan Breanne Moore

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

495 N Shilling Ave
Blackfoot, ID 83221-2336

Phone

(435) 744-3535

NPI assigned

Jun 20, 2025

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

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.

• Snake River Family Services

  • Adolescent and Children Mental Health Clinic/Center
  • Blackfoot, ID
  • NPI 1861215295
  NPD

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

{
    "created_epoch": "1750377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750377600000",
    "number": "1679460810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "591 TURIN WAY APT 26101",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834401583",
            "telephone_number": "760-881-5773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 N SHILLING AVE",
            "city": "BLACKFOOT",
            "state": "ID",
            "postal_code": "832212336",
            "telephone_number": "435-744-3535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JORDAN",
        "middle_name": "BREANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-20",
        "last_updated": "2025-06-20",
        "certification_date": "2025-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "ID",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jody Jon McLaws
• MH Health Care Services, PC
• Camile Michaelson, RD, LD
• Robert Nathan Miller, PHARM-D
• Tanner D Mitton, PA-C
• Alex Morgan, CRNA
• Zachary D Morrow
• Amy Moser, M.S. CCC-SLP
• Francis Bryce Moser, DO
• Mountain River Birthing and Surgery Center LLC (Grove Creek Medical Center)

• Case Manager/Care Coordinator in Blackfoot, ID
• Providers in Blackfoot, ID by specialty
• Case Manager/Care Coordinator in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2025; 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.