Jody Ann Moore

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP003738 Issued in GA

Practice address

405 Love Ave
Tifton, GA 31794-4403

Phone

(229) 402-7188

NPI assigned

Jun 27, 2022

Last updated

Jun 27, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Golden Speech Therapy, Inc

  • Hearing and Speech Clinic/Center
  • Tifton, GA
  • NPI 1073041919

  Single Specialty

  NPD

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

{
    "created_epoch": "1656288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656288000000",
    "number": "1700518958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2608 MURRAY AVE",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317942823",
            "telephone_number": "229-392-5753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 LOVE AVE",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317944403",
            "telephone_number": "229-402-7188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JODY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-27",
        "last_updated": "2022-06-27",
        "certification_date": "2022-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP003738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Moon's Pharmacy LTC (Moon's Pharmacy Inc)
• Alexandra Rose Moore
• Frederick Haygood Moore
• Holly Georgiana Moore, COTA/L
• Jessica Nichole Moore, FNP-C
• Linda Moore, RD
• Stacey Moore
• Brandi Moorman, FNP-C
• Casey Moran, DPT
• Emilee Marie Morehead, PHARMD

• Speech-Language Pathologist in Tifton, GA
• Providers in Tifton, GA by specialty
• Speech-Language Pathologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2022; 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.