MR. SPENCER GABRIEL MOORE (NPI# 1083257216) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083257216 |
| Entity Type | Individual |
| Full Name | MR. SPENCER GABRIEL MOORE |
| Credential | QBHP |
| Practice Address |
602 David St Corning AR 72422-7268 |
| Mailing Address |
2707 Browns Ln Jonesboro AR 72401-7213 |
| Practice Telephone | 8708753655 |
| Practice Fax Number | 8708573667 |
| Mailing Telephone | 8709724939 |
| Mailing Fax Number | 8709724911 |
| Enumeration Date | 2019-10-21 |
| Last Update Date | 2019-10-21 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710535778 | Spencer Elise Moore | Optometrist | 100 N Tryon St Ste 280, Charlotte, NC 28202-4004 | 2019-09-03 |
| 1497794192 | Spencer V Moore | Optometrist | 1215 Lake Air Dr, Waco, TX 76710-4419 | 2006-06-06 |
| 1235750670 | Spencer Moore | Internal Medicine | 1501 N Campbell Ave, Tucson, AZ 85724-5040 | 2020-04-27 |
| 1831604396 | Spencer Edmund Moore | Behavior Technician | 1260 Ekhart St Ne, Grand Rapids, MI 49503-1380 | 2017-12-06 |
| 1285165530 | Spencer Harding Moore | Student in an Organized Health Care Education/Training Program | 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 | 2017-03-27 |
| 1770928517 | Spencer Keith Moore | Case Manager/Care Coordinator | 1804 Highway 45 Byp, Suite 604, Jackson, TN 38305-4436 | 2013-05-07 |
| Street Address |
602 DAVID ST |
| City | CORNING |
| State | AR |
| Zip Code | 72422-7268 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104077676 | Northeast Arkansas Community Mental Health Center | Counselor | 602 David St, Corning, AR 72422-7268 | 2008-10-02 |
| 1275132508 | Christopher Whittaker | Case Manager/Care Coordinator | 602 David St, Corning, AR 72422-7268 | 2020-10-19 |
| 1922615384 | Allison N Bradish | Case Manager/Care Coordinator | 602 David St, Corning, AR 72422-7268 | 2020-09-29 |
| 1205441342 | Emily Green | Case Manager/Care Coordinator | 602 David St, Corning, AR 72422-7268 | 2020-09-15 |
| 1841818333 | James T Freeman | Licensed Practical Nurse | 602 David St, Corning, AR 72422-7268 | 2020-07-10 |
| 1376169615 | Amy Freeman | Licensed Practical Nurse | 602 David St, Corning, AR 72422-7268 | 2020-06-23 |
| 1942832688 | Cody L Anderson | Case Manager/Care Coordinator | 602 David St, Corning, AR 72422-7268 | 2020-02-11 |
| 1598397226 | Kandra E Leonard | Case Manager/Care Coordinator | 602 David St, Corning, AR 72422-7268 | 2020-02-11 |
| 1831739838 | Paul Prevo | Case Manager/Care Coordinator | 602 David St, Corning, AR 72422-7268 | 2020-01-08 |
| 1770123606 | Sydney Haggard | Case Manager/Care Coordinator | 602 David St, Corning, AR 72422-7268 | 2020-01-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639326341 | Michele Ann Crancer | Speech-Language Pathologist | 510 Wynn Park Drive, Corning, AR 72422 | 2008-08-25 |
| 1639104920 | Stacy R Arnell | Social Worker | 602 David Street, Corning, AR 72422 | 2006-07-12 |
| 1285046896 | Krystal Dawn Upshaw | Podiatrist | 1300 Creason Rd, Corning, AR 72422 | 2014-06-02 |
| 1316211469 | Lisa Lynn Vinal | Nurse Practitioner | 1300 Creason Rd, Corning, AR 72422 | 2012-03-06 |
| 1538431556 | Susie Elaine Flanery | Social Worker | 1300 Creason Rd, Corning, AR 72422 | 2012-02-07 |
| 1023230661 | Corning Public Schools | Local Education Agency (LEA) | 500 Bobcat Lane, Corning, AR 72422-0479 | 2007-05-03 |
| 1003951278 | Karen R Crawley | Speech-Language Pathologist | 2503 Cherry St, Corning, AR 72422-1315 | 2007-02-21 |
| 1649821844 | Jill Ann Foster | Nurse's Aide | 301 Griggs Ln, Corning, AR 72422-1425 | 2019-09-28 |
| 1700211489 | Bradley Chiropractic Center, LLC | Chiropractor | 301 N Missouri Ave, Suite 17, Corning, AR 72422-1600 | 2013-09-12 |
| 1134291818 | Piggott Community Hospital | Durable Medical Equipment & Medical Supplies | 301 N Missouri Ave Ste 17, Corning, AR 72422-1603 | 2006-11-15 |
| Find all providers in zip 72422 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457829079 | Leray Marie Oliver | Case Manager/Care Coordinator | 7585 Township Road 331 Se, Corning, OH 43730-9702 | 2018-11-13 |
| 1275132508 | Christopher Whittaker | Case Manager/Care Coordinator | 602 David St, Corning, AR 72422-7268 | 2020-10-19 |
| 1922615384 | Allison N Bradish | Case Manager/Care Coordinator | 602 David St, Corning, AR 72422-7268 | 2020-09-29 |
| 1205441342 | Emily Green | Case Manager/Care Coordinator | 602 David St, Corning, AR 72422-7268 | 2020-09-15 |
| 1942832688 | Cody L Anderson | Case Manager/Care Coordinator | 602 David St, Corning, AR 72422-7268 | 2020-02-11 |
| 1598397226 | Kandra E Leonard | Case Manager/Care Coordinator | 602 David St, Corning, AR 72422-7268 | 2020-02-11 |
| 1831739838 | Paul Prevo | Case Manager/Care Coordinator | 602 David St, Corning, AR 72422-7268 | 2020-01-08 |
| 1770123606 | Sydney Haggard | Case Manager/Care Coordinator | 602 David St, Corning, AR 72422-7268 | 2020-01-08 |
| 1932744265 | Shaina Marie Carpenter | Case Manager/Care Coordinator | 602 David St, Corning, AR 72422-7268 | 2019-11-11 |
| 1558904797 | Shelby Marie Patrick | Case Manager/Care Coordinator | 602 David St, Corning, AR 72422-7268 | 2019-10-21 |
| Find all providers in CORNING | ||||
Please comment or provide details below to improve the information on MR. SPENCER GABRIEL MOORE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.