Active NPI
Jackson Moorefield
- Orthopaedic Surgery Physician
- Greenville, SC
National Provider Identifier
1740031756
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- LL91519
- Practice address
- 13 Edgewood Dr
Greenville, SC 29605-4235 - Phone
- (864) 455-7861
- NPI assigned
- Mar 28, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | LL91519 | SC | Primary |
Addresses
Primary practice location
13 Edgewood Dr
Greenville, SC 29605-4235
Mailing address
13 Edgewood Dr
Greenville, SC 29605-4235
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LL91519 | SC | MD | Orthopaedic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1711584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724976000000",
"number": "1740031756",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13 EDGEWOOD DR",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296054235"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13 EDGEWOOD DR",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296054235",
"telephone_number": "864-455-7861"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOOREFIELD",
"first_name": "JACKSON",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-03-28",
"last_updated": "2024-08-30",
"certification_date": "2024-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "SC",
"license": "LL91519",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.