Jasmyn Lynn Moore

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

12252A Issued in NC

Practice address

5 Corporate Center CT Unit 200-a
Greensboro, NC 27408-2033

Phone

(336) 257-0404

NPI assigned

Jan 7, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jasmyn Lynn Bobbs Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 1, 2024 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1609977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609977600000",
    "number": "1861080533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 RASHEEDA CT",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274063846",
            "telephone_number": "336-383-2613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 CORPORATE CENTER CT UNIT 200-A",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274082033",
            "telephone_number": "336-257-0404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JASMYN",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-07",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NC",
            "license": "12252A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Greensboro",
            "affiliation": "N",
            "address_1": "5 Corporate Center Ct Unit 200-A",
            "city": "Greensboro",
            "state": "NC",
            "country_code": "US",
            "postal_code": "274082033",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JASMYN",
            "last_name": "BOBBS",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Destiny R Moore, MPH, IBCLC
• Erika Moore
• Gwendolyn Moore, NCC, LCMHC
• James Ervin Moore Jr., PA-C
• Janece Moore, FNP-BC
• Jodi Lynn Moore, OTD, OTR/L, CHT
• Joseph Gray Moore, ATC, EMT-I
• Kalie Moore, MA, LCMHC
• Kendall S Moore
• Kyle Moore, LCSW, LCAS, MSW

• Marriage & Family Therapist in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Marriage & Family Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.