Individual provider Active NPI

Jacob Evans Moore

  • Student in an Organized Health Care Education/Training Program
  • Huntsville, AL
National Provider Identifier
1730761107
Registry record updated Apr 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
8 Wadsworth Dr
Huntsville, AL 35808-1007
Phone
(503) 367-4706
NPI assigned
Apr 26, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

8 Wadsworth Dr
Huntsville, AL 35808-1007

Mailing address

8 Wadsworth Dr
Huntsville, AL 35808-1007
Phone (503) 367-4706

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251008001218 LA Practitioner - Anesthesiology 5193129856 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Alabama College of Osteopathic Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ochsner Clinic LLCGroup PAC ID 8224933619, 2,845 clinicians

Practice addresses (Care Compare)

1514 Jefferson Hwy
New Orleans, LA 70121-2429
Phone (504) 842-3000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Ochsner Clinic LLC Current Accepting new patients
Ochsner Clinic LLC CurrentSince Jul 28, 2025 Accepting new patients
Ochsner Clinic LLC CurrentSince Jul 28, 2025 Accepting new patients

Locations

180 W Esplanade Ave
Kenner, LA 70065
Phone (504) 464-8284

1057 Paul Maillard Rd
Luling, LA 70070
Phone (985) 785-3655

1514 Jefferson Hwy
New Orleans, LA 70121

2700 Napoleon Ave
New Orleans, LA 70115
Phone (504) 842-3650

1221 S Clearview Pkwy
New Orleans, LA 70121
Phone (504) 736-4600

2500 Belle Chasse Hwy
Terrytown, LA 70056
Phone (504) 391-5157

Interoperability endpoints

  • Direct secure messaging: jmoore1283145@direct.ochsner.org

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1619395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619395200000",
    "number": "1730761107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 WADSWORTH DR",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358081007",
            "telephone_number": "503-367-4706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 WADSWORTH DR",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358081007",
            "telephone_number": "503-367-4706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JACOB",
        "middle_name": "EVANS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-26",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.