DR. MICHAEL N MOODY (NPI# 1063489821) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1063489821 |
Entity Type | Individual |
Full Name | DR. MICHAEL N MOODY |
Credential | M.D. |
Practice Address |
507 N Main St Salem AR 72576-9449 |
Mailing Address |
Po Box 829 Salem AR 72576-0829 |
Practice Telephone | 8708952541 |
Practice Fax Number | 8708952957 |
Mailing Telephone | 8708952541 |
Mailing Fax Number | 8708952957 |
Enumeration Date | 2006-03-01 |
Last Update Date | 2010-12-22 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 208D00000X | General Practice | C-4622 | AR | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
AR | 102259001 | 05 | |
MO | MEDICAID | 200621308 | 01 |
AR | QUALCHOICE | 127780000 | 01 |
AR | BLUE CROSS BLUE SHIELD | 53743 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1760739825 | Michael S Moody | Dentist | 6200 N Durango Dr Ste 100, Las Vegas, NV 89149 | 2012-08-08 |
1952466583 | Michael Shannon Moody | Family Medicine | 8464 Adair Sreet, Douglasville, GA 30134-1877 | 2006-12-26 |
1033204094 | Michael Derrick Moody | Oral & Maxillofacial Surgery | 9990 W 26th Ave, Suite 100, Lakewood, CO 80215-1581 | 2006-10-04 |
1649652538 | Michael Moody | Pharmacist | 2301 Holmes St, Kansas City, MO 64108-2640 | 2015-06-26 |
1871890368 | Michael D Moody | Nurse Anesthetist, Certified Registered | 1444 Peterman Dr, Alexandria, LA 71301-3432 | 2011-02-17 |
1437180783 | Michael Anthony Moody | Pediatrics | 4101 N Roxboro St, Durham, NC 27704-2121 | 2006-07-05 |
Street Address |
507 N MAIN ST |
City | SALEM |
State | AR |
Zip Code | 72576-9449 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1265414247 | Spring River Home Health Agency Inc | Home Health | 507 N Main St, Salem, AR 72576-9449 | 2005-11-16 |
1164557351 | Connie F. Bray | Nurse Anesthetist, Certified Registered | 507 N Main St, Salem, AR 72576 | 2007-02-21 |
1891880555 | Paul David Kauffman | Family Medicine | 507 N Main St, Salem, AR 72576-9449 | 2006-10-04 |
1164499935 | Jimmy G Bozeman | General Practice | 507 N Main St, Salem, AR 72576-9449 | 2006-03-01 |
1376519454 | Salem Family Clinic | General Practice | 507 N Main St, Salem, AR 72576-9449 | 2006-02-27 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1205476322 | Spring River Therapy | Occupational Therapy Assistant | 1323 Hwy 9 N, Salem, AR 72576 | 2020-01-07 |
1326691213 | Tiffany Jean Reed | Occupational Therapy Assistant | 115 Watters Street, Salem, AR 72576 | 2019-07-19 |
1821564436 | Bokker Enterprises, Inc. | Community/Behavioral Health | 115 Turner Lane, Ste #2, Salem, AR 72576 | 2018-10-22 |
1346790649 | Rebekah Alexander | Social Worker | 684 Highway 62 412, Salem, AR 72576 | 2016-10-11 |
1407209075 | Mirenda Martin | Clinical Nurse Specialist | 507 N Main Street, Salem Family Clinic 507 N Main Street, Salem, AR 72576 | 2016-07-19 |
1982004362 | Alternative Oppurtunities | Community/Behavioral Health | 684 Sky Vu Shopping Center, Highway 412 West, Salem, AR 72576 | 2014-09-04 |
1144465485 | Jennifer Renee Innis | Physical Therapy Assistant | 679 North Main Street, Salem, AR 72576 | 2008-12-15 |
1922261890 | Fulton County Hospital | Clinic/Center | 673 North Main St, Salem, AR 72576 | 2008-07-09 |
1659573327 | Barbara Scott | Nurse Practitioner | 172 Highway 62 East, Salem, AR 72576 | 2007-06-04 |
1609995653 | Watch Care, LLC | Hospice Care, Community Based | 106 West Locust, Salem, AR 72576 | 2007-03-29 |
Find all providers in zip 72576 |
Taxonomy Code | 208D00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | General Practice |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1821342429 | Stephanie Nicole Reedy | General Practice | 2515 Liberty St Ne, Salem, OR 97301-8386 | 2012-11-04 |
1427207265 | John M Vargo | General Practice | 4305 Camas Ct Ne, Salem, OR 97305-2207 | 2008-09-17 |
1275797417 | Lagrand Johnson | General Practice | 326 Highway 6, Salem, UT 84653-5620 | 2008-07-16 |
1235392242 | John Mark Pozar | General Practice | 998 Capitol St Ne, Salem, OR 97301-1201 | 2008-07-09 |
1912175035 | Salem Clinic, PC | General Practice | 2531 Boone Road Se, Salem, OR 97306 | 2008-02-11 |
1104028364 | Ivan Dassenko | General Practice | 6810 Canyon St Se, Salem, OR 97317-9024 | 2007-06-01 |
1073668935 | Terence H Young | General Practice | 1205 Wallace Rd Nw, Salem, OR 97304-3007 | 2007-01-23 |
1639243348 | Thomas R Howard | General Practice | 567 Salem Quinton Rd, Ste C, Salem, NJ 08079-1255 | 2006-11-17 |
1023083722 | Brent K. Caudill | General Practice | Hwy 72 N, Salem, MO 65560 | 2006-02-17 |
1316456965 | Anton Dubrick Md Sc | General Practice | 420 W Schwartz St, Salem, IL 62881-1552 | 2017-09-27 |
Find all providers in SALEM |
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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.