NPIMap

Organization Active NPI

Jennifer Moore, M.D., PA

  • Specialist
  • Sebastian, FL
National Provider Identifier
1700062809
Registry record updated Jan 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME90718 Issued in FL
Legal business name
JENNIFER MOORE, M.D., PA
Practice address
7764 Bay St Ste 10
Sebastian, FL 32958-3427
Phone
(772) 228-9787
Fax
(772) 563-0370
NPI assigned
Jan 18, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2008

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

Authorized official

Name
Dr. Jennifer Moore, M.D.
Title
Owner
Phone
(772) 228-9787

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X ME90718 FL Primary

Addresses

Primary practice location

7764 Bay St Ste 10
Sebastian, FL 32958-3427

Mailing address

7764 Bay St Ste 10
Sebastian, FL 32958-3427
Phone (772) 228-9787

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1200614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201651200000",
    "number": "1700062809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7764 BAY ST STE 10",
            "city": "SEBASTIAN",
            "state": "FL",
            "postal_code": "329583427",
            "telephone_number": "772-228-9787",
            "fax_number": "772-563-0370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7764 BAY ST STE 10",
            "city": "SEBASTIAN",
            "state": "FL",
            "postal_code": "329583427",
            "telephone_number": "772-228-9787",
            "fax_number": "772-563-0370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNIFER MOORE, M.D., PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-18",
        "last_updated": "2008-01-30",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "772-228-9787",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME90718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sebastian, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2008; 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.