Spencer Keith Moore, CW

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

1804 Highway 45 Byp
Suite 604
Jackson, TN 38305-4436

Phone

(731) 660-7971

Fax

(731) 660-8739

NPI assigned

May 7, 2013

Sex

Male

Sole proprietor

No

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

Practice roles

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.

• Pathways of Tennessee, Inc.

  • Clinic/Center
  • Jackson, TN
  • NPI 1497721609
  NPD (past)

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

{
    "created_epoch": "1367884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410134400000",
    "number": "1770928517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2035 SAINT JOHN AVE",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380242209",
            "telephone_number": "731-541-8200",
            "fax_number": "731-660-8739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1804 HIGHWAY 45 BYP",
            "address_2": "SUITE 604",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383054436",
            "telephone_number": "731-660-7971",
            "fax_number": "731-660-8739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "SPENCER",
        "middle_name": "KEITH",
        "credential": "CW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-07",
        "last_updated": "2014-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hope B Moore, CRNA
• Jamey Moore, MS
• Miracle Moore, RBT
• Patricia Ann Moore, MT
• Samantha Nichole Moore
• Sidney Moragne, MD
• Nina Morey, CASE MANAGER
• Morningside of Jackson, LLC
• Brent Jerome Morris, M.D.
• Inyang Morris, APRN, PMHNP-BC

• Case Manager/Care Coordinator in Jackson, TN
• Providers in Jackson, TN by specialty
• Case Manager/Care Coordinator in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2014; 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.