JERRI KATHLEEN MOORE (NPI# 1407940547) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407940547 |
| Entity Type | Individual |
| Full Name | JERRI KATHLEEN MOORE |
| Credential | MD |
| Practice Address |
1306 Doctors Drive Tyler TX 75701 |
| Practice Telephone | 9035921890 |
| Practice Fax Number | 9035923222 |
| Mailing Telephone | 9035921890 |
| Mailing Fax Number | 9035923222 |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2018-07-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | J0605 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | MEDICAL LIS | J0605 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962018218 | Jerri Moore | Technician | 7517 Cobal Canyon Ln, Las Vegas, NV 89129-2903 | 2020-09-22 |
| 1295235679 | Jerri Dawn Moore | Counselor | 14572 Us Highway 23 Ste A, Waverly, OH 45690-9448 | 2018-02-13 |
| 1265745673 | Jerri Denise Moore | Counselor | 820 Park Dr, Ste Genevieve, MO 63670-1566 | 2010-07-15 |
| Street Address |
1306 DOCTORS DRIVE |
| City | TYLER |
| State | TX |
| Zip Code | 75701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962057059 | Gonzalo Fernandez | Physical Therapy Assistant | 753 S Beckham Ave, Tyler, TX 75701 | 2019-08-06 |
| 1215422654 | Adrianna Bussell | Nurse Practitioner | 1000 South Beckham, Tyler, TX 75701 | 2018-06-28 |
| 1285128017 | Idowu Akintokunbo Akinyele | Dentist | Aspen Dental, 4164 S Broadway Ave, Tyler, TX 75701 | 2018-06-15 |
| 1992208912 | Heather Renee Vancleave | Occupational Therapy Assistant | 1228 Louann Lane, Tyler, TX 75701 | 2018-03-15 |
| 1497260533 | Smile Workshop Mckinney, Pllc | Dentist | 301 N. Custer Rd, Mckinney, TX 75701 | 2017-12-12 |
| 1396266441 | Eye Surgery Center of East Texas, Pllc | Clinic/Center | 2448 E 5th St, Tyler, TX 75701 | 2017-06-29 |
| 1962936369 | Collins Complete Family Care | Nurse Practitioner | 1910 E Se Loop 323 # 176, Tyler, TX 75701 | 2017-04-12 |
| 1386187052 | Fellowship Health Team LLC | Home Health | 1124 S Fleishel Ave, Tyler, TX 75701 | 2016-11-29 |
| 1205382454 | Brenton Robinson | Nurse Practitioner | 1100 East Lake St, 160, Tyler, TX 75701 | 2016-08-28 |
| 1851846208 | Care First Pharmacy, LLC | Pharmacy | 1910 Roseland Blvd A, Tyler, TX 75701 | 2016-08-15 |
| Find all providers in zip 75701 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073842514 | St. Paul Children's Medical Corporation | Pediatrics | 1358 E Richards St, Tyler, TX 75702-6153 | 2009-12-11 |
| 1770791717 | Genevieve J.t. Blackwelder | Pediatrics | 6526 Ashmore Ln, Tyler, TX 75703-5896 | 2007-05-21 |
| 1356445647 | William D Rishel | Pediatrics | 1130 Doctors Dr, Tyler, TX 75701-2123 | 2006-09-08 |
| 1730299306 | Tiffany Hill | Pediatrics | 1000 E 5th St Ste 100, Tyler, TX 75701-3307 | 2006-08-30 |
| 1649201484 | Rachel Jean Osina Nichols | Pediatrics | 1350 E Richards St, Tyler, TX 75702-6153 | 2006-07-06 |
| 1639107675 | Andrew E Hoover | Pediatrics | 1000 Fifth Street, Tyler, TX 75701 | 2006-06-29 |
| 1356316681 | Jennifer A Steeger | Pediatrics | 305 W Rusk St, Tyler, TX 75701-1514 | 2006-02-21 |
| 1841265477 | James Rick Rogers | Pediatrics | 706 Turtle Creek, Tyler, TX 75701 | 2006-02-17 |
| 1912971813 | Wendell A Jones | Pediatrics | 2990 N Broadway, Tyler, TX 75702 | 2006-02-15 |
| 1134199284 | Michael David Austin | Pediatrics | 1000 E 5th St, Tyler, TX 75701-3346 | 2006-01-23 |
| Find all providers in TYLER | ||||
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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.