DR. SHANNON MONIQUE MOORE (NPI# 1154636611) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1154636611 |
Entity Type | Individual |
Full Name | DR. SHANNON MONIQUE MOORE |
Credential | PHD |
Practice Address |
1675 Lakeland Dr Ste 304 Jackson MS 39216 |
Mailing Address |
Po Box 13563 Jackson MS 39236-3563 |
Practice Telephone | 7695244578 |
Practice Fax Number | 7695244630 |
Mailing Telephone | 7695244578 |
Mailing Fax Number | 7695244630 |
Enumeration Date | 2010-08-09 |
Last Update Date | 2019-03-22 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 103TC0700X |
Psychologist Specialization: Clinical |
55981 | MS | Behavioral Health & Social Service Providers |
Address | Telephone Number | Fax Number |
---|---|---|
1818 Albion St Ste 114, Nashville, TN 372082918 | 6153274751 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1043825565 | Shannon Roberta Moore | In Home Supportive Care | 5686 Broadview Rd Apt 2520, Parma, OH 44134-1647 | 2020-09-11 |
1033764055 | Shannon Moore | Physical Therapist | 235 Open Sky Way, Kila, MT 59920-7700 | 2019-08-06 |
1770006660 | Shannon Moore | Optometrist | 340 Wood Rd Ste 2020, Braintree, MA 02184-2404 | 2017-07-21 |
1316327851 | Shannon Moore | Technician, Other | 24837 Princeton St, Dearborn, MI 48124-4457 | 2015-05-30 |
1659713071 | Shannon Lori Moore | Dietitian, Registered | 1114 Thomasville Rd Ste G, Tallahassee, FL 32303-6273 | 2013-07-26 |
1326388893 | Shannon Michelle Moore | Developmental Therapist | 340 Ralley Rd, Keavy, KY 40737-2729 | 2013-02-21 |
1639414345 | Shannon L Moore | Licensed Practical Nurse | 1235 3rd Street, Sedro-woolley, WA 98284 | 2012-12-06 |
1669767208 | Shannon M Moore | Pharmacist | 80 Baker St, Richmond, VT 05477-7750 | 2011-06-11 |
1689630246 | Shannon Jessica Moore | Optometrist | 528 Waterloo Rd, Warrenton, VA 20186-3011 | 2006-04-24 |
1144863176 | Shannon Moore | Behavior Technician | 901 O St, Suite C, Arcata, CA 95521-5789 | 2019-10-22 |
Street Address |
1675 LAKELAND DR STE 304 |
City | JACKSON |
State | MS |
Zip Code | 39216 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1861011553 | Ashley Melancon Prewitt | Registered Nurse | St. Dominic's North Campus, Behavioral Health, Jackson, MS 39216 | 2020-04-13 |
1194353391 | Brianna Arrington | Student in an Organized Health Care Education/Training Program | Med/ Peds, 2500 N. State St., Jackson, MS 39216 | 2020-04-01 |
1720616485 | Roshina Khalid Khan | Student in an Organized Health Care Education/Training Program | Department of Anesthesiology, Ummc, 2500 N. State St., Jackson, MS 39216 | 2020-03-30 |
1275183550 | Amanda Lynn Morellato | Dentist | Ummc School of Dentistry, 2500 North State Street, Jackson, MS 39216 | 2019-09-18 |
1396305553 | Abhishek Chhabra | Student in an Organized Health Care Education/Training Program | Lakeland Family Medicine Clinic, 878 Lakeland Dr., Jackson, MS 39216 | 2019-06-19 |
1427615996 | Hometown Diagnostics | Clinical Medical Laboratory | Translational Research Center Tr311, 2500 North State Street, Jackson, MS 39216 | 2019-05-21 |
1346807773 | Shukundala C Smith | Behavior Technician | New Learning Resources 2510 Lakeland Terrace, Jackson, MS 39216 | 2019-05-21 |
1063901098 | G Eli Howell Md Pllc | Plastic Surgery | 971 Lakeland Dr Ste 225, Jackson, MS 39216 | 2018-05-04 |
1588168132 | Caleb Zumbro | Student in an Organized Health Care Education/Training Program | Ummc Med/peds, 2500 N. State St., Jackson, MS 39216 | 2018-03-20 |
1639677230 | Walgreen Co | Pharmacy | 971 Lakeland Dr Ste 101, Jackson, MS 39216 | 2018-01-29 |
Find all providers in zip 39216 |
Taxonomy Code | 103TC0700X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Psychologist |
Specialization | Clinical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1043756174 | Maribeth L. Hesser | Psychologist | 6675 N Upper Cascade Dr, Jackson, WY 83001-9390 | 2017-01-12 |
1215375746 | Payne Behavioral Medicine | Psychologist | 4005 N State St Ste N, Jackson, MS 39206-5755 | 2013-06-06 |
1598002610 | Kimberly D Weaver | Psychologist | 207 First Street, Jackson, MI 49201 | 2013-01-09 |
1497027775 | Fitness Clinic | Psychologist | 2219 Greenway Dr, Jackson, MS 39204-3202 | 2012-02-02 |
1760752976 | Mitchell S. Weisbrod, Psy.d., Pllc | Psychologist | 115 S West Ave Ste 1, Jackson, MI 49201-2085 | 2012-01-04 |
1275830887 | Martin E Cleveland Phd Pllc | Psychologist | 5 Brentmeade Cv, Jackson, TN 38305-6448 | 2011-02-16 |
1598076903 | Nanetta S Payne | Psychologist | 4005 N State St, Suite N, Jackson, MS 39206-5755 | 2010-06-30 |
1932422763 | Marion Counseling Services, Pllc | Psychologist | 2095 Dunbarton Dr, Suite 103, Jackson, MS 39216-5017 | 2010-03-08 |
1457548737 | Deborah Ruddy Hansen | Psychologist | 6 Universal Way, Jackson, MI 49202-1455 | 2007-10-01 |
1902006737 | Ena C Knott-scott | Psychologist | 1264 Wooddell Dr, Jackson, MS 39212-4045 | 2007-07-19 |
Find all providers in JACKSON |
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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.