DR. JACK MOORE MD NPI 1467426221

NPI Information

NPI: 1467426221
Provider Name: DR. JACK MOORE, MD
Classification: Internal Medicine - 207RN0300X
Entity Type: Individual

Specialization: Nephrology

PECOS Registration: Yes

Address:
3800 RESERVOIR RD NW
WASHINGTON, DC
ZIP 20007
Phone: (202) 877-6034
Get Directions

DR. Jack Moore, MD is a nephrology internal medicine in Washington, DC. The provider is an internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. DR. Jack Moore, MD NPI is 1467426221. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3800 RESERVOIR RD NW
WASHINGTON, DC
ZIP 20007-113
Phone: (202) 877-6034
Fax: (202) 877-8329

The NPI 1467426221 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 2/16/2006 and was last updated on 6/16/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	174400000X	Specialist		MD19916	DISTRICT OF COLUMBIA	No
2	207RN0300X	Internal Medicine	Nephrology	MD19916	DISTRICT OF COLUMBIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	025615700	MEDICAID	DISTRICT OF COLUMBIA
2	5817889	MEDICAID	VIRGINIA
3	042931700	MEDICAID	MARYLAND
4	015572YT2	MEDICARE PIN	DISTRICT OF COLUMBIA
5	F65447	MEDICARE UPIN	DISTRICT OF COLUMBIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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