JENNIFER M MOSS (NPI# 1164819603) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164819603 |
| Entity Type | Organization |
| Organization Name | JENNIFER M MOSS |
| Other Organization Name | CONCHO VALLEY OB-GYN |
| Practice Address |
3019 Green Meadow Dr San Angelo TX 76904-6975 |
| Practice Telephone | 3259449999 |
| Practice Fax Number | 3259449996 |
| Mailing Telephone | 3259449999 |
| Mailing Fax Number | 3259449996 |
| Enumeration Date | 2015-04-22 |
| Last Update Date | 2015-09-29 |
| Authorized Official Name | JENNIFER MICHELE MOSS (SOLE PROPRIETOR) |
| Authorized Official Telephone | 3259449999 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
K7835 | TX | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | NPI | 1508019993 | 01 |
| Other Name | Type Code |
|---|---|
| Concho Valley OB-GYN | Doing Business As Name - Organization |
| Street Address |
3019 GREEN MEADOW DR |
| City | SAN ANGELO |
| State | TX |
| Zip Code | 76904-6975 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508019993 | Jennifer M Moss | Obstetrics & Gynecology | 3019 Green Meadow Dr, San Angelo, TX 76904-6975 | 2008-10-29 |
| 1487251955 | Rebecca Thorpe | Behavior Technician | 3019 Green Meadow Dr, San Angelo, TX 76904-6975 | 2020-10-07 |
| 1083221592 | Sarah Jo Laurent | Technician, Other | 3019 Green Meadow Dr, San Angelo, TX 76904-6975 | 2020-09-29 |
| 1487215778 | Tyler Henderson | Behavior Technician | 3019 Green Meadow Dr, San Angelo, TX 76904-6975 | 2019-06-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407342702 | Mark Wandal Duncan | Specialist/Technologist | 2237 South Jackson, San Angelo, TX 76904 | 2018-07-10 |
| 1700267259 | Sheila Patterson | Nurse Practitioner | 4251 Sunset Drive, San Angelo, TX 76904 | 2015-06-10 |
| 1346649316 | Mason William Mcclintock | Dentist | 2402 College Hills Blvd. Building 1, Building 1, San Angelo, TX 76904 | 2014-08-15 |
| 1265855712 | Lynn M. Thebo, Lcsw, Pllc | Social Worker | 3109 Southwest Blvd. Ste. B, San Angelo, TX 76904 | 2014-02-03 |
| 1487077459 | Lynn Marie Thebo | Social Worker | 3109 Southwest Blvd., Ste. B, San Angelo, TX 76904 | 2014-01-28 |
| 1558646521 | John Porter Parker Jr. | Pharmacist | 3705 Threewn Trail, San Angelo, TX 76904 | 2011-10-20 |
| 1568772036 | Medical Alliance Group of Texas, LLC | Durable Medical Equipment & Medical Supplies | 2525 S Johnson Ste A, San Angelo, TX 76904 | 2010-10-18 |
| 1578796710 | Jennifer L White | Physical Therapist | 2237 S. Jackson, San Angelo, TX 76904 | 2009-09-03 |
| 1548443203 | Kelly K. Sawyer, D.d.s., P.a. | Dentist | 3013 W. Loop 306, San Angelo, TX 76904 | 2007-12-17 |
| 1023224789 | D&s Residential Services | Intermediate Care Facility, Mentally Retarded | 1706 Idaho Avenue, San Angelo, TX 76904 | 2007-05-16 |
| Find all providers in zip 76904 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
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|---|---|---|---|---|
| 1306386081 | The Waterford Wellness Spa | Clinic/Center | 602 S. Abe, San Angelo, TX 76903 | 2017-03-01 |
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| 1164061644 | Iari | Clinic/Center | 12606 Greenville Ave Ste 190b, Dallas, TX 75243-1921 | 2019-12-31 |
| 1366081192 | Sprout Chiropractic Pllc | Clinic/Center | 3421 W William Cannon Dr Ste 145, Austin, TX 78745-5002 | 2019-12-26 |
| 1902369101 | Banerji Plastic Surgery | Clinic/Center | 11914 Astoria Blvd Ste 580, Houston, TX 77089-5975 | 2019-04-13 |
| 1831653526 | Naveli Medical Services, Pllc | Clinic/Center | 9090 Gaylord Dr Ste 200, Houston, TX 77024-2948 | 2019-01-26 |
| 1740758606 | Landry's Elite Medical Enterprise, Pllc | Clinic/Center | 3204 Melody Peak Ln, Pearland, TX 77581-2555 | 2018-11-08 |
| 1982179602 | Spring Center of Hope | Clinic/Center | 20008 Champion Forest Dr Ste 1202, Spring, TX 77379-8697 | 2018-10-09 |
| 1609378801 | Express Anesthesia & Pain Management Consultants,pllc | Clinic/Center | 6609 W Sam Houston Pkwy S Ste 101, Houston, TX 77072-1641 | 2018-03-02 |
| 1902313588 | Bbg Cosmetic and Plastic Surgery | Clinic/Center | 5930 W Parker Rd Ste 600, Plano, TX 75093-6420 | 2018-01-04 |
| Find all providers with the same taxonomy | ||||
| City | SAN ANGELO |
| Zip Code | 76904 |
Please comment or provide details below to improve the information on JENNIFER M MOSS.
| 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.