Jeffrey L Moore, PHD

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

0810001376 Issued in VA

Practice address

220 Hovey Rd
Pensacola, FL 32508-1044

Phone

(850) 452-2157

Fax

(850) 452-2690

NPI assigned

Jan 12, 2006

Sex

Male

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

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1137024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184716800000",
    "number": "1750360293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8870 BURNING TREE RD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325145602",
            "telephone_number": "850-474-1147",
            "fax_number": "850-474-1147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 HOVEY RD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325081044",
            "telephone_number": "850-452-2157",
            "fax_number": "850-452-2690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JEFFREY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-12",
        "last_updated": "2007-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "VA",
            "license": "0810001376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abigail Moore, CRNA
• Amanda Springer Moore, NP-C
• Ashley Robin Moore, B.S.N.
• Hailey Maria Moore, LCSW
• Jaylin Ryan Moore, M.A.
• Jon M Moore, MD
• Kasey Moore, LMHC
• Kyle Moore
• Martha Denise Moore
• Megan Spearman Moore, CRNA

• Clinical Neuropsychologist in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Clinical Neuropsychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2007; 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.