JACQUELINE P. MOORE (NPI# 1679620488) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679620488 |
| Entity Type | Individual |
| Full Name | JACQUELINE P. MOORE |
| Credential | M.D. |
| Practice Address |
Henry Ford Health System 22777 W. Eleven Mile Rd Southfield MI 48034 |
| Practice Telephone | 2483580722 |
| Practice Fax Number | 2483588658 |
| Mailing Telephone | 2483580722 |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 4301038170 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| COMMERCIAL-COMMERCIAL NUMBER | JM038170 | 01 | |
| CHAMPUS-CHAMPUS | JM038170 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689222754 | Jacqueline Blair Moore | Counselor | 14651 Dallas Pkwy Ste 134, Dallas, TX 75254-8904 | 2019-08-30 |
| 1376103838 | Jacqueline Faith Moore | Marriage & Family Therapist | 5450 Ralston St Ste 101, Ventura, CA 93003-6042 | 2019-06-17 |
| 1033611256 | Jacqueline Moore | Registered Nurse | 314 Main St Ste D, Monticello, MS 39654-3702 | 2018-03-03 |
| 1952655466 | Jacqueline Adele Moore | Massage Therapist | 1048 Spinnaker St, Elgin, IL 60123-8587 | 2012-11-06 |
| 1659649002 | Jacqueline Historian Moore | Licensed Practical Nurse | 6256 Hillandale Dr Apt 803, Lithonia, GA 30058-2432 | 2011-12-13 |
| 1619173838 | Jacqueline Diana Moore | Surgery | 2280 Opitz Blvd Ste 110, Woodbridge, VA 22191-3362 | 2007-06-25 |
| 1962059980 | Jacqueline Moore | Speech-Language Pathologist | 5980 Radio Station Rd, La Plata, MD 20646-3337 | 2019-08-23 |
| 1336702638 | Jacqueline Dyan Moore | Student in an Organized Health Care Education/Training Program | 800 Garfield Ave Rm G102, Parkersburg, WV 26101-5340 | 2019-04-22 |
| 1336702315 | Jacqueline Moore | Developmental Therapist | 6239 S East St Ste A, Indianapolis, IN 46227-2088 | 2019-04-16 |
| 1598235889 | Jacqueline Marie Moore | Nurse Practitioner | 101 E 8th St Ste 110, Vancouver, WA 98660-3294 | 2018-11-29 |
| Street Address |
HENRY FORD HEALTH SYSTEM 22777 W. ELEVEN MILE RD |
| City | SOUTHFIELD |
| State | MI |
| Zip Code | 48034 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053458653 | Terry R. Gordon | Internal Medicine | Henry Ford Health System, 22777 W. Eleven Mile Rd, Southfield, MI 48034 | 2007-01-31 |
| 1346317716 | Marc C. Lewis | Obstetrics & Gynecology | Henry Ford Health System, 22777 W. Eleven Mile Rd, Southfield, MI 48034 | 2006-11-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780219196 | I. R. Horn & Associates LLC | Community/Behavioral Health | 29623 Norhtwestern Hwy Suite 5, Southfield, MI 48034 | 2020-03-05 |
| 1003378753 | Alexis Shivers | Physical Therapy Assistant | 27500 Lahser Rd, Southfield, MI 48034 | 2019-04-02 |
| 1598257768 | El-abbadi Pediatric Clinic | Pediatrics | 24676 Lahser Road, Southfield, MI 48034 | 2018-06-04 |
| 1689166894 | Recore Rehabilitation Services | Clinic/Center | 25899 W 12 Mile Rd # 340, Southfield, MI 48034 | 2018-06-04 |
| 1578063749 | El-abbadi Healthcare Center | Clinic/Center | 27403 Lahser Rd, Southfield, MI 48034 | 2018-02-14 |
| 1063924819 | Diagnostic Hematology, PC | Clinical Medical Laboratory | 24725 W. Twelve Mile Road, Suite 118, Southfield, MI 48034 | 2017-11-02 |
| 1962929125 | Toms Holistic Home Visits Pllc | Clinic/Center | 28675 Franklin Rd, Suite 217, Southfield, MI 48034 | 2017-08-28 |
| 1265956940 | Abbadi Healthcare | Pharmacy | 27402 Lahser Road, Southfield, MI 48034 | 2017-08-03 |
| 1720517113 | Theramedic Home Health Care LLC | Home Health | 26400 W. 12 Mile Rd, Suite 80, Southfield, MI 48034 | 2017-06-08 |
| 1538695804 | Adrienne Rutherford | Occupational Therapist | 25999 Franklin Pointe Dr, Southfield, MI 48034 | 2017-05-05 |
| Find all providers in zip 48034 | ||||
| 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 |
|---|---|---|---|---|
| 1598257768 | El-abbadi Pediatric Clinic | Pediatrics | 24676 Lahser Road, Southfield, MI 48034 | 2018-06-04 |
| 1184993404 | Hasan Hasaba Md Pllc | Pediatrics | 22255 Greenfield Rd Ste 320, Southfield, MI 48075-3729 | 2011-12-14 |
| 1235148222 | Eliyahou Kam | Pediatrics | 22255 Greenfield Ste 128, Providence Pavilion, Southfield, MI 48075 | 2006-08-07 |
| 1932126752 | Sarveswararao Talla | Pediatrics | 17356 W 12 Mile Rd, Suite 100, Southfield, MI 48076-2128 | 2006-07-16 |
| 1477537157 | Amy E Youn | Pediatrics | 30503 Greenfield Rd, Southfield, MI 48076-1594 | 2005-12-06 |
| 1568460152 | Marie-jeanne D Monde-matthews | Pediatrics | 29255 Northwestern Hwy, Suite 100, Southfield, MI 48034-1018 | 2005-07-08 |
| 1245859446 | Vpa PC | Pediatrics | 21540 W 11 Mile Rd Ste 200, Southfield, MI 48076-3843 | 2020-04-09 |
| 1669091864 | Vpa PC | Pediatrics | 21540 W 11 Mile Rd Ste 200, Southfield, MI 48076-3843 | 2020-04-09 |
| 1902325384 | Peace & Harmony Services LLC | Pediatrics | 17330 Northland Park Ct, Southfield, MI 48075-4318 | 2017-09-16 |
| 1326422908 | Marisa Elias | Pediatrics | 22777 W 11 Mile Rd, Southfield, MI 48033 | 2015-07-14 |
| Find all providers in SOUTHFIELD | ||||
| City | SOUTHFIELD |
| Zip Code | 48034 |
Please comment or provide details below to improve the information on JACQUELINE P. 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.