DR. JACOB RYAN MOORE (NPI# 1831719947) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831719947 |
| Entity Type | Individual |
| Full Name | DR. JACOB RYAN MOORE |
| Credential | D.O. |
| Practice Address |
2100 Stantonsburg Rd Greenville NC 27834-2818 |
| Practice Telephone | 2527444757 |
| Practice Fax Number | 2527444125 |
| Mailing Telephone | 2527444757 |
| Mailing Fax Number | 2527444125 |
| Enumeration Date | 2020-04-17 |
| Last Update Date | 2020-04-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154617058 | Jacob E Moore | Emergency Medicine | 2326 N Lincoln Park W Apt 4b, Chicago, IL 60614-3446 | 2011-06-20 |
| 1043459175 | Jacob B Moore | Physical Medicine & Rehabilitation | 2707 Stange Road Suite 102, Mcfarland Clinic PC, Ames, IA 50010-3014 | 2009-02-12 |
| 1144249277 | Jacob Jackson Moore | Ophthalmology | 900 Morgan Ave, Corpus Christi, TX 78404-2028 | 2006-07-19 |
| 1497384424 | Jacob Aaron Moore | Nurse Practitioner | 800 Rose St, Lexington, KY 40536-7001 | 2020-04-02 |
| 1255892287 | Jacob James Moore | Psychiatry & Neurology | 155 N Fresno St, Fresno, CA 93701-2302 | 2019-03-31 |
| 1336644723 | Jacob Clark Moore | Student in an Organized Health Care Education/Training Program | 250 Park St, Bowling Green, KY 42101-1760 | 2018-03-27 |
| 1821512179 | Jacob Moore | Specialist/Technologist | 116 Ward Sports Medicine Building, Greenville, NC 27858 | 2017-07-28 |
| 1588027007 | Jacob Moore | Pharmacist | 1745 Quentin Rd, Lebanon, PA 17042-7435 | 2016-04-01 |
| 1750762928 | Jacob Robert Moore | Emergency Medicine | 5841 S Maryland Ave Rm L539, Chicago, IL 60637-1447 | 2015-06-14 |
| 1851780928 | Jacob Moore | Physician Assistant | 1900 Silver Lake Rd Nw, Suite 110, New Brighton, MN 55112-1786 | 2015-01-13 |
| Street Address |
2100 STANTONSBURG RD |
| City | GREENVILLE |
| State | NC |
| Zip Code | 27834-2818 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902802077 | Leanna F. Thorn | Emergency Medicine | 2100 Stantonsburg Rd, Greenville, NC 27834-2818 | 2005-06-23 |
| 1891394557 | Schuyler Geaslen Williams | Nurse Practitioner | 2100 Stantonsburg Rd, Greenville, NC 27834-2818 | 2020-10-22 |
| 1477169084 | Denise Harper | Clinical Nurse Specialist | 2100 Stantonsburg Rd, Greenville, NC 27834-2818 | 2020-09-18 |
| 1548874068 | Ileen Craven | Registered Nurse | 2100 Stantonsburg Rd, Greenville, NC 27834-2818 | 2020-09-02 |
| 1790397990 | Randi Elizabeth Caruso | Nurse Practitioner | 2100 Stantonsburg Rd, Greenville, NC 27834-2818 | 2020-08-19 |
| 1184236333 | Emily Merritt | Pharmacist | 2100 Stantonsburg Rd, Greenville, NC 27834-2818 | 2020-08-19 |
| 1467063107 | Smit Rajput | Internal Medicine | 2100 Stantonsburg Rd, Greenville, NC 27834-2818 | 2020-08-15 |
| 1558971044 | Kyle Travlos | Registered Nurse | 2100 Stantonsburg Rd, Greenville, NC 27834-2818 | 2020-08-09 |
| 1114537693 | Ryan Austin Wagner | Registered Nurse | 2100 Stantonsburg Rd, Greenville, NC 27834-2818 | 2020-08-09 |
| 1790395283 | Clayton Adams | Registered Nurse | 2100 Stantonsburg Rd, Greenville, NC 27834-2818 | 2020-08-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841801255 | Nicholas Mcarthur Bennett | Day Training, Developmentally Disabled Services | 302 C, Greenville, NC 27834 | 2020-08-11 |
| 1275150245 | Shelby Renee Jones | Student in an Organized Health Care Education/Training Program | East Carolina University College of Nursing, 600 Moye Blvd, Greenville, NC 27834 | 2020-06-25 |
| 1194347138 | Soban Ahmad | Student in an Organized Health Care Education/Training Program | 600 Moye Blvd., Vmc Ma Room 350. Internal Medicine Resi, Mailstop #734, Greenville, NC 27834 | 2020-05-13 |
| 1427687789 | Brandon Allen Yates | Student in an Organized Health Care Education/Training Program | 435 Clinic Drive, Greenville, NC 27834 | 2020-04-07 |
| 1144854407 | Kristen Springer Dreyfus | Marriage & Family Therapist | 2609 West Arlington Blvd Suite 106, Greenville, NC 27834 | 2020-02-26 |
| 1861038606 | Southern Surgical Outpatient Surgery Center, Pa | Clinic/Center | 2457 Emerald Place, Greenville, NC 27834 | 2019-11-26 |
| 1003460569 | Shaun Fitzpatrick | Nurse Practitioner | Physicians East, Pa 1850 W. Arlington Blvd., Greenville, NC 27834 | 2019-08-01 |
| 1649831496 | Katherine Salome Ross | Genetic Counselor, MS | 524 Moye Blvd, Greenville, NC 27834 | 2019-06-24 |
| 1477011880 | Lauren Bethune Scroggs | Counselor | 2150 West 5th Street, Health Sciences Building Mailstop 688, Greenville, NC 27834 | 2019-03-05 |
| 1669998001 | Idella's Care Home | Community/Behavioral Health | 2912 Lee Ct # 9a, Greenville, NC 27834 | 2017-08-17 |
| Find all providers in zip 27834 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275141327 | Anne M. Stollberg | Student in an Organized Health Care Education/Training Program | 3 Pheasant Ct, Greenville, SC 29607-5441 | 2020-07-15 |
| 1275150245 | Shelby Renee Jones | Student in an Organized Health Care Education/Training Program | East Carolina University College of Nursing, 600 Moye Blvd, Greenville, NC 27834 | 2020-06-25 |
| 1245856723 | Brittany Nicole Simpson | Student in an Organized Health Care Education/Training Program | 100 Chandler Dr Apt E, Greenville, NC 27834-6034 | 2020-06-22 |
| 1972129484 | Morgan Cox | Student in an Organized Health Care Education/Training Program | 901 Treybrooke Cir Apt 14, Greenville, NC 27834-7879 | 2020-06-20 |
| 1588289995 | Ashley Belle Stein | Student in an Organized Health Care Education/Training Program | 202 N Harding St, Greenville, NC 27858-1326 | 2020-06-11 |
| 1366066177 | Brittany Janofski | Student in an Organized Health Care Education/Training Program | 306 Treybrooke Cir Apt 33, Greenville, NC 27834-5961 | 2020-06-08 |
| 1669096293 | Victoria Chapman Woodward | Student in an Organized Health Care Education/Training Program | 201 Millbrook St, Greenville, NC 27834-5647 | 2020-05-29 |
| 1033732037 | Erin Gold | Student in an Organized Health Care Education/Training Program | 1440 Treybrooke Cir, Greenville, NC 27834-9159 | 2020-05-26 |
| 1376166421 | Brittney Cannon | Student in an Organized Health Care Education/Training Program | 2202a Sweet Bay Dr, Greenville, NC 27834-2535 | 2020-05-24 |
| 1275155186 | Israel Miguel Mendez | Student in an Organized Health Care Education/Training Program | 1401 E 10th St Apt 109, Greenville, NC 27858-3115 | 2020-05-13 |
| Find all providers in GREENVILLE | ||||
| City | GREENVILLE |
| Zip Code | 27834 |
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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.