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JONATHAN PERRY MOORE LLC
NPI 1982486643
Counselor - Mental Health in Holland, MI

Active since October 17, 2023PECOS Enrolled
170 COLLEGE AVE STE 310, HOLLAND, MI 49423(616) 745-6748 Get Directions Write a Review

NPPES record last updated: October 17, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Jonathan Perry Moore Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JONATHAN PERRY MOORE LLC (NPI 1982486643) is an individual mental health provider in Holland, Michigan, licensed in Michigan (6451023316) and active in the NPI registry since October 2023. He is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1982486643
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameJONATHAN PERRY MOORECredential: LLC
Location Address170 COLLEGE AVE STE 310Holland, MI 49423-2982
Mailing Address170 College Ave Ste 310Holland, MI 49423-2982 · (616) 745-6748
Phone(616) 745-6748
Sole ProprietorNo
Medical School CMSOtherGraduated 2023
Enumeration DateOctober 17, 2023
NPPES CertifiedOctober 17, 2023
✔ NPI 1982486643 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in MI · 6451023316
170 COLLEGE AVE STE 310, Holland, MI 49423
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jonathan Perry Moore Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2769974427
PECOS Enrollment IDI20251120003655
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Jonathan Moore reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Second Story Counseling II LLC
13 mi
Counselor
3424 CHICAGO DR STE 205
Hudsonville, MI 49426
  • Reassigned Medicare billing, Michigan enrollment
  • 36 clinicians in this Medicare group
NPI 1013460716 (616) 426-9034

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NATALYA BUSSCHER
Counselor (Professional)
170 COLLEGE AVE STE 310
HOLLAND, MI 49423
Allegan County (616) 426-9034
MRS. ELINEKE VANDERHAM MA, LLC
Counselor (Mental Health)
170 COLLEGE AVE STE 310
HOLLAND, MI 49423
Allegan County (616) 426-9034
LAUREL RAE BACKING LLPC
Counselor
170 COLLEGE AVE STE 310
HOLLAND, MI 49423
Allegan County (616) 426-9034
GRACE THOMPSON MDIV, LLMSW
Social Worker (Clinical)
170 COLLEGE AVE STE 310
HOLLAND, MI 49423
Allegan County (616) 426-9034
RACHEL LYNN KYLE MA, LLPC
Counselor (Professional)
170 COLLEGE AVE STE 310
HOLLAND, MI 49423
Allegan County (616) 426-9034
SARAH BETH EGBERT MA, LLC, LSC
Counselor (Mental Health)
170 COLLEGE AVE STE 310
HOLLAND, MI 49423
Allegan County (616) 426-9034
SELENA LYNN METCALF-WRIGHT MA
Counselor (Mental Health)
170 COLLEGE AVE STE 310
HOLLAND, MI 49423
Allegan County (616) 426-9034
BRYAN MICHAEL JACKSON
Social Worker (Clinical)
170 COLLEGE AVE STE 310
HOLLAND, MI 49423
Allegan County (616) 426-9034

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jonathan Moore's NPI number?

The NPI number for Jonathan Moore is 1982486643. It was assigned to this individual provider in the NPPES registry on October 17, 2023.

Where is Jonathan Moore located?

Jonathan Moore practices at 170 College Ave Ste 310, Holland, MI 49423. The listed phone number is (616) 745-6748.

What is Jonathan Moore's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Jonathan Moore enrolled in Medicare?

Yes. Jonathan Moore is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jonathan Moore's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jonathan Moore reassigns Medicare benefits to Second Story Counseling II LLC (Hudsonville, MI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jonathan Moore's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jonathan Moore accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company and 3 other insurers list Jonathan Moore as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jonathan Moore was last updated on October 17, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.