DR. JORGE LUIS MORENO SR. (NPI# 1518904242) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518904242 |
| Entity Type | Individual |
| Full Name | DR. JORGE LUIS MORENO SR. |
| Credential | M.D. |
| Practice Address |
375 Mcdonough Rd Jackson GA 30233-1509 |
| Practice Telephone | 7707754622 |
| Practice Fax Number | 7707754132 |
| Mailing Telephone | 7707754622 |
| Mailing Fax Number | 7707754132 |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2014-07-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 022255 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 00211549A | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831726793 | Jorge Victor Moreno | Anesthesiology | 1507 Nw 107th Ter, Gainesville, FL 32606-5491 | 2020-03-23 |
| 1245882208 | Jorge Luis Moreno | Pharmacist | 131 Fm 3168, Raymondville, TX 78580-3605 | 2019-07-10 |
| 1073001137 | Jorge Humberto Moreno | Student in an Organized Health Care Education/Training Program | 4801 Alberta Ave, El Paso, TX 79905-2707 | 2018-04-24 |
| 1306118393 | Jorge Luis Moreno | Nutritionist | 420 N Montebello Blvd, Suite 300, Montebello, CA 90640-4268 | 2012-02-06 |
| 1821387036 | Jorge O Moreno | Internal Medicine | 800 Howard Ave, New Haven, CT 06519 | 2011-03-29 |
| 1518914597 | Jorge Luis Moreno Jr. | Family Medicine | 375 Mcdonough Rd, Jackson, GA 30233-1509 | 2006-05-27 |
| Street Address |
375 MCDONOUGH RD |
| City | JACKSON |
| State | GA |
| Zip Code | 30233-1509 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649223587 | Seema Moreno | Occupational Therapist | 375 Mcdonough Rd, Jackson, GA 30233-1509 | 2006-05-19 |
| 1699815340 | Maldonado & Moreno, PC | Family Medicine | 375 Mcdonough Rd, Jackson, GA 30233-1509 | 2007-02-08 |
| 1518914597 | Jorge Luis Moreno Jr. | Family Medicine | 375 Mcdonough Rd, Jackson, GA 30233-1509 | 2006-05-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366800914 | Georgia Ophthalmologists LLC | Durable Medical Equipment & Medical Supplies | 860 W 3rd St, Jackson, GA 30233 | 2016-02-10 |
| 1306225057 | Young Dreaden | Nurse Practitioner | 2978 Hwy 36w, Jackson, GA 30233 | 2015-05-28 |
| 1609255520 | Neta J Roby | Nurse Practitioner | Hwy 36, Georgia Diagnostic Classification Prison, Jackson, GA 30233 | 2015-05-26 |
| 1033546098 | Henrietta Lindsay | Social Worker | 463-b Ernest Biles Dr, Jackson, GA 30233 | 2013-10-04 |
| 1255776993 | Gareth Gene Walker | Technician | 514 Covinton Street, Jackson, GA 30233 | 2013-05-08 |
| 1730489592 | Mary L. Melton | Licensed Practical Nurse | 463 Ernest Biles Dr., Jackson, GA 30233 | 2010-10-27 |
| 1083864250 | Chastity Moore Brown | Dentist | 1520 Lucky Street, Griffin, GA 30233 | 2008-09-24 |
| 1568661320 | Joseph Fowlkes | Internal Medicine | 2978 Highway 36 W, Jackson, GA 30233 | 2007-07-12 |
| 1942386289 | Butts County Board of Commissioners | Ambulance | 154 Sylvan Drive, Jackson, GA 30233 | 2006-10-30 |
| 1841238300 | Jackson Pharmacy Services | Pharmacy | 22 Mulberry St., Jackson, GA 30233 | 2006-06-04 |
| Find all providers in zip 30233 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366991523 | Jackson State University | General Practice | 1400 Jr Lynch St, Jackson, MS 39217-0002 | 2016-09-29 |
| 1124475371 | Donald Lafont | General Practice | 331 Edenwood Dr, Jackson, TN 38301-3432 | 2016-05-18 |
| 1669717302 | Lift Wellness Inc | General Practice | 101 Jackson Walk Plaza, Jackson, TN 38301 | 2012-12-06 |
| 1457665333 | Teton County Hospital District | General Practice | Box 428 625 E Broadway Ave, Jackson, WY 83001-8642 | 2010-08-03 |
| 1851524730 | Byrd Lamar Payne | General Practice | 1205 Lyncrest Ave, Jackson, MS 39202-2106 | 2009-08-26 |
| 1801031703 | Total Spine Surgical Center LLC | General Practice | 1455 College Ave, Jackson, AL 36545-2410 | 2008-12-05 |
| 1992974018 | Visiting Doctors PC | General Practice | 2108 4th St Ste A, Jackson, MI 49203-4518 | 2008-02-22 |
| 1821127093 | Peter Thomas Gardner | General Practice | 2075 Pleasant Plains Ext Rd, Jackson, TN 38305-6087 | 2007-03-05 |
| 1154491579 | Bruce Hayse | General Practice | 269 West Broadway, Jackson, WY 83001-1884 | 2006-11-09 |
| 1104880558 | Lorna Gaye Pinson | General Practice | 3235 East Michigan Ave, Jackson, MI 49202 | 2006-04-13 |
| 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.