Jedd Moore, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

59377 Issued in ID

Practice address

300 W Myrtle St Ste 100
Boise, ID 83702-7690

Phone

(208) 472-9082

NPI assigned

Sep 20, 2018

Last updated

Jul 15, 2021By 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

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Ohio State University College of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Alliance Medical Group LLCGroup PAC ID 3971544685, 132 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Luke's Regional Medical Center Hospital, Boise, ID, CCN 130006

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jedd.moore@phmg.eclinicaldirectplus.com

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.

• Alliance Medical Group, LLC

  dba Primary Health Medical Group

  • Family Medicine Physician
  • Garden City, ID
  • NPI 1568413920
  Medicare reassignment Care Compare group NPD
• Alliance Medical Group, LLC

  dba Primary Health Medical Group

  • Family Medicine Physician
  • Boise, ID
  • NPI 1487326203
  NPD
• Alliance Medical Group, LLC

  dba Primary Health Medical Group

  • Family Medicine Physician
  • Boise, ID
  • NPI 1497991749
  NPD (past)
• Alliance Medical Group, LLC

  dba Primary Health Medical Group

  • Family Medicine Physician
  • Boise, ID
  • NPI 1821361387
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Lukes Regional Medical Center

  dba Air St Luke's

  • Ambulance
  • Boise, ID
  • NPI 1518115195

  Hospital

  Care Compare affiliation
• St Lukes Regional Medical Center

  dba St Lukes Meridian Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1770586794
  Care Compare affiliation

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

{
    "created_epoch": "1537401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626307200000",
    "number": "1902380371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 191050",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837191050",
            "telephone_number": "208-955-6522",
            "fax_number": "208-955-6503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W MYRTLE ST STE 100",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837027690",
            "telephone_number": "208-472-9082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JEDD",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-20",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "59377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Moore, RRT
• Gary L Moore, LCSW
• Harold Guy Moore, MD
• Illaria C Moore, NP-C
• Jaclyn Moore, LCPC
• Joan Moore, MS, GC
• Katherine McEntee Moore, MED CCC-SLP
• Keith Michael Moore, LPC
• Kelly Moore, NP
• Kyra Moore, RN

• Nurse Practitioner in Boise, ID
• Providers in Boise, ID by specialty
• Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.