JENNETTA SHIMELL MOORE (NPI# 1629678271) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629678271 |
| Entity Type | Individual |
| Full Name | JENNETTA SHIMELL MOORE |
| Credential | LPN |
| Practice Address |
3215 Old Vineyard Rd Winston Salem NC 27103-1411 |
| Practice Telephone | 3363549047 |
| Mailing Telephone | 3363549047 |
| Enumeration Date | 2020-10-31 |
| Last Update Date | 2020-10-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | 90648 | NC | Nursing Service Providers |
| Street Address |
3215 OLD VINEYARD RD |
| City | WINSTON SALEM |
| State | NC |
| Zip Code | 27103-1411 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124648126 | Kelly Anne Wales | Pharmacist | 3917-a Westpoint Boulevard, Winston-salem, NC 27103 | 2020-04-20 |
| 1386281533 | Elena Mcginty | Nurse Practitioner | 1225 Creekshire Way, Suite 270, Winston Salem, NC 27103 | 2019-12-06 |
| 1992359442 | Madeline Pryor | Pharmacist | 255 Charlois Drive, Winston Salem, NC 27103 | 2019-08-01 |
| 1215599584 | Palmetto Oxygen LLC | Durable Medical Equipment & Medical Supplies | 1100 S Stratford Road, Building B, Suite 420, Winston Salem, NC 27103 | 2019-07-07 |
| 1548734718 | Trivy Johnson | Specialist | 1384-b Westgate Center Dr., Winston Salem, NC 27103 | 2019-01-21 |
| 1447745047 | Novant Health Rehabilitation Hospital of Winston-salem, LLC | Rehabilitation Hospital | 2475 Hillcrest Center Circle, Winston Salem, NC 27103 | 2018-06-26 |
| 1346740206 | Joseph Miller | Physical Therapist | 1605 Westbrook Dr, Suite 103, Winston-salem, NC 27103 | 2018-02-17 |
| 1548779101 | Kristin Blow | Counselor | 3000 Bethesda Pl Ste 202, Winston Salem, NC 27103 | 2017-09-27 |
| 1891213443 | Alisha Dawn Wilson | Occupational Therapy Assistant | 2101 Homestead Hills Drive, Winston Salem, NC 27103 | 2017-09-05 |
| 1588186969 | Brandy Wilson | Social Worker | 153 Cameron Way Circle, Winston Salem, NC 27103 | 2017-07-07 |
| Find all providers in zip 27103 | ||||
| Taxonomy Code | 164W00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Practical Nurse |
| An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437767654 | Deshawna Mcclain | Licensed Practical Nurse | 334 Troy Lndg, Winston Salem, NC 27107-2678 | 2020-07-14 |
| 1003450388 | Mary Elizabeth Green | Licensed Practical Nurse | 650 Highland Ave # 100, Winston Salem, NC 27101-4304 | 2019-10-30 |
| 1134781156 | Ariel Tilisha Thomas | Licensed Practical Nurse | 990 Stafford Forest Dr Apt 301, Winston Salem, NC 27127-6912 | 2019-06-29 |
| 1841767522 | Bobbi Jo Walsh | Licensed Practical Nurse | 326 Maynard South Dr, Winston Salem, NC 27107-2017 | 2018-10-31 |
| 1730631516 | Tracy D Chambers | Licensed Practical Nurse | 1010 W. Northwest Blvd, Winston Salem, NC 27101 | 2016-10-27 |
| 1295027886 | Lavonda Propst Hazaimh | Licensed Practical Nurse | 3851 Heather View Ln, Winston Salem, NC 27127-4511 | 2011-05-14 |
| 1851938401 | Charlotte Elizabeth Steele | Licensed Practical Nurse | 650 Highland Ave, Winston Salem, NC 27101-4304 | 2019-12-03 |
| 1194376822 | Javaun Margaret Patterson | Licensed Practical Nurse | 650 Highland Ave Ste 110, Winston Salem, NC 27101-4304 | 2019-09-24 |
| 1588141485 | Holly Ann Medeiros | Licensed Practical Nurse | 650 Highland Ave, Winston Salem, NC 27101-4304 | 2018-07-24 |
| 1700374964 | Jennifer Rose Smith | Licensed Practical Nurse | 725 Highland Ave Unit 100, Winston Salem, NC 27101-4181 | 2018-04-24 |
| Find all providers in WINSTON SALEM | ||||
| City | WINSTON SALEM |
| Zip Code | 27103 |
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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.