Healthcare Provider Details

I. General information

NPI: 1467721183
Provider Name (Legal Business Name): PALLIATIVE CARE SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2011
Last Update Date: 07/09/2025
Certification Date: 07/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2030 HAMILTON PLACE BLVD STE 220
CHATTANOOGA TN
37421-6040
US

IV. Provider business mailing address

500 FAULCONER DR STE 200
CHARLOTTESVILLE VA
22903-5089
US

V. Phone/Fax

Practice location:
  • Phone: 434-235-4123
  • Fax:
Mailing address:
  • Phone: 434-977-9711
  • Fax: 434-235-4142

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JESSE R MOORE
Title or Position: CHIEF ADMINISTRATIVE OFFICER
Credential:
Phone: 857-331-6271