Active NPI
Jennifer Loadholt Moore, LMSW
- Social Worker
- Ridgeland, SC
National Provider Identifier
1942547138
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 10158
- Practice address
- 204 North Railroad Avenue
Ridgeland, SC 29936 - Phone
- (843) 645-7700
- NPI assigned
- Jan 9, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 10158 | SC | Primary |
Addresses
Primary practice location
204 North Railroad Avenue
Ridgeland, SC 29936
Mailing address
PO Box 1343
Ridgeland, SC 29936-2623
Phone (843) 645-7700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10158 | Other | SC | DEPARTMENT OF LABOR, LICENSING AND REGULATION BOARD OF SOCIAL WORK EXAMINERS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10158 | SC | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1357689600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1357689600000",
"number": "1942547138",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1343",
"city": "RIDGELAND",
"state": "SC",
"postal_code": "299362623",
"telephone_number": "843-645-7700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "204 NORTH RAILROAD AVENUE",
"city": "RIDGELAND",
"state": "SC",
"postal_code": "29936",
"telephone_number": "843-645-7700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "JENNIFER",
"middle_name": "LOADHOLT",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-01-09",
"last_updated": "2013-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "SC",
"license": "10158",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPARTMENT OF LABOR, LICENSING AND REGULATION BOARD OF SOCIAL WORK EXAMINERS",
"identifier": "10158",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ridgeland, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 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.