JENNIFER KRISTIN MOORE L.AC., DOM (NM), NPI 1982982914 — PHOENIX (AZ)

NPI 1982982914

8+ Years Experience Individual

JENNIFER KRISTIN MOORE L.AC., DOM (NM)

07/25/2011
PROVIDER ENUMERATION DATE
01.08.2013
LAST UPDATE DATE
1982982914
NPI NUMBER

About JENNIFER KRISTIN MOORE

Sole proprietor? Yes, Entity Type 1 Provider (Individual) is a Sole Proprietor.

JENNIFER KRISTIN MOORE is a provider established in PHOENIX, AZ. The NPI number of JENNIFER KRISTIN MOORE is 1982982914 and was assigned on 07/25/2011. The practitioners primary taxonomy code is: 171100000X with license number: 843 AZ .

Mailing address

  • City: PHOENIX
  • State: AZ
  • Postal code: 850425684
  • Phone: 5053146767
  • Fax: 4807591669
  • Address: 7306 S 12TH PL

Primary Practice Address

  • Region : PHOENIX, AZ
  • NPI : 1982982914
  • Phone : 4807591668
  • Fax : 4807591669
  • Postalcode : 850487296
  • Address : 3233 E CHANDLER BLVD STE 3

Provider taxonomy - Acupuncturist

  • Taxonomy code: 171100000X
  • License number: 843
  • License state: AZ

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Taxonomy description: An acupuncturist is a person who performs ancient therapy for alleviation of pain, anesthesia and treatment of some diseases. Acupuncturists use long, fine needles inserted into specific points in order to treat painful conditions or produce anesthesia.

Healthcare provider taxonomy #2 - Acupuncturist

  • Taxonomy code: 171100000X
  • License number: 1052
  • License state: NM

The taxonomy is not the primary taxonomy.

Taxonomy description: An acupuncturist is a person who performs ancient therapy for alleviation of pain, anesthesia and treatment of some diseases. Acupuncturists use long, fine needles inserted into specific points in order to treat painful conditions or produce anesthesia.

Contacts:

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  • JENNIFER KRISTIN MOORE L.AC., DOM (NM)
  • Address : 3233 E CHANDLER BLVD STE 3
  • Region : PHOENIX, AZ
  • NPI : 1982982914
  • Phone : 4807591668
  • Fax : 4807591669
  • Postalcode : 850487296

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address3233 E CHANDLER BLVD STE 3
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NamePHOENIX
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameAZ
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code850487296
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number4807591668
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number4807591669
The fax number associated with the location address of the provider being identified.
NPI1982982914
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1171100000X
An acupuncturist is a person who performs ancient therapy for alleviation of pain, anesthesia and treatment of some diseases. Acupuncturists use long, fine needles inserted into specific points in order to treat painful conditions or produce anesthesia.
Provider Enumeration Date07/25/2011
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated01.08.2013
The date that a record was last updated or changed.
Entity TypeIndividual
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)JENNIFER KRISTIN MOORE
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing Address7306 S 12TH PL
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Business Mailing Address City NamePHOENIX
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameAZ
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code850425684
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number5053146767
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number4807591669
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Healthcare Provider Taxonomy Code #1171100000X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Acupuncturist
An acupuncturist is a person who performs ancient therapy for alleviation of pain, anesthesia and treatment of some diseases. Acupuncturists use long, fine needles inserted into specific points in order to treat painful conditions or produce anesthesia.
Provider License Number 1843
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 1AZ
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Healthcare Provider Taxonomy Code 2171100000X
Healthcare Provider Taxonomy 2Acupuncturist
An acupuncturist is a person who performs ancient therapy for alleviation of pain, anesthesia and treatment of some diseases. Acupuncturists use long, fine needles inserted into specific points in order to treat painful conditions or produce anesthesia.
Provider License Number 21052
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 2NM
Healthcare Provider Primary Taxonomy Switch 2N
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Provider Gender CodeF
  • M - male
  • F - female
Is sole proprietorY
  • X - Not Answered
  • Y - Yes, Entity Type 1 Provider (Individual) is a Sole Proprietor
  • N - No, Entity Type 1 Provider (Individual) is not a Sole Proprietor
X

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