Chevois Johnson Moore Jr., LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C001361 Issued in NC

Practice address

3828 Providence Rd
Rocky Mount, NC 27803-1158

Phone

(252) 451-1878

NPI assigned

Jun 30, 2006

Last updated

Feb 5, 2013By the provider in NPPES

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

Other identifiers 1

Other names 1

• C Johnson Moore Jr. Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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

• Wilson Greene Mental Health

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  • NPI 1417017963
  NPD (past)
• Paradigm Health Care Services, LLC

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  • NPI 1336190495
  NPD (past)

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360022400000",
    "number": "1851320295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3828 PROVIDENCE RD",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278031158",
            "telephone_number": "252-451-1878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3828 PROVIDENCE RD",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278031158",
            "telephone_number": "252-451-1878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "CHEVOIS",
        "middle_name": "JOHNSON",
        "name_suffix": "Jr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2013-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C001361",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6003504",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "C",
            "last_name": "MOORE",
            "middle_name": "JOHNSON",
            "suffix": "JR.",
            "credential": "LCSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Monarch
• Monarch
• Monarch
• Monique Brown, MD PC
• Rickie Kelvin Monroe, MD
• Julie Moore
• Kenneth Moore
• Latanya Renee Moore, LMFT
• Wendy Richardson Moore, CDE
• Scott Morelli

• Clinical Social Worker in Rocky Mount, NC
• Providers in Rocky Mount, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2013; 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.