DEREK MOELLER (NPI# 1184725558) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184725558 |
| Entity Type | Individual |
| Full Name | DEREK MOELLER |
| Credential | M.D. |
| Practice Address |
208 Country Club Rd Houston MS 38851-9326 |
| Mailing Address |
1114 Commonwealth Blvd Tupelo MS 38804-9301 |
| Practice Telephone | 6624563437 |
| Practice Fax Number | 6624522070 |
| Mailing Telephone | 6624563437 |
| Mailing Fax Number | 6624522070 |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2016-10-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | MS17537 | MS | Allopathic & Osteopathic Physicians |
| Y | 207R00000X | Internal Medicine | 17537 | MS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00125350 | 05 | |
| MS | 09013750 | 05 |
| Street Address |
208 COUNTRY CLUB RD |
| City | HOUSTON |
| State | MS |
| Zip Code | 38851-9326 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710097134 | North Mississippi Medical Clinics Inc | Family Medicine | 208 Country Club Rd, Houston, MS 38851-9326 | 2006-08-30 |
| 1316477607 | William Morgan | Family Medicine | 208 Country Club Rd, Houston, MS 38851-9326 | 2017-06-19 |
| 1073920328 | Pontotoc Health Services, Inc. | Clinic/Center | 208 Country Club Rd, Houston, MS 38851-9326 | 2014-07-18 |
| 1093817306 | Angela Furr | Nurse Practitioner | 208 Country Club Rd, Houston, MS 38851-9326 | 2006-09-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144742073 | Natalie Mitchell | Social Worker | 102 Okolona Cutoff Rd, Houston, MS 38851 | 2017-07-12 |
| 1073041042 | Jan Sherlene Paden | Nurse Practitioner | 8 East Madison St, Houston, MS 38851 | 2017-06-02 |
| 1851772818 | Shell Denece Williams-moore | Religious Nonmedical Practitioner | 901 North Jackson Street, Houston, MS 38851 | 2015-06-16 |
| 1740385491 | Southern Health Corp of Houston Inc | Skilled Nursing Facility | 1000 East Madison, Houston, MS 38851 | 2006-09-14 |
| 1730281809 | Teena Freeman Horn | Dentist | 327 N Jackson St, Houston, MS 38851 | 2006-09-01 |
| 1891776530 | Kunthavai S. Patel | Specialist | 208 Country Club Road, Houston, MS 38851 | 2005-11-09 |
| 1255467726 | North Mississippi Foot Specialists PC | Durable Medical Equipment & Medical Supplies | Hwy 8 East, Houston, MS 38851 | 2007-02-26 |
| 1689753485 | Southern Health Corp of Houston Inc | Psychiatric Unit | Highway 8 East, Houston, MS 38851 | 2006-11-03 |
| 1306925102 | Southern Health Corp of Houston Inc | Medicare Defined Swing Bed Unit | Highway 8 East, Houston, MS 38851 | 2006-11-03 |
| 1134212038 | Chickasaw Dental Group L. L. C. | Dentist | 327 N Jackson St, Houston, MS 38851 | 2006-10-02 |
| Find all providers in zip 38851 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
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| 1134744873 | Manoj B Vakil Md Pa | Internal Medicine | 1801 North Loop W Ste 42, Houston, TX 77008-1445 | 2020-06-09 |
| 1912526997 | Obur Health Pa | Internal Medicine | 1700 Post Oak Blvd Ste 600, Houston, TX 77056-3973 | 2020-04-10 |
| 1841824489 | Senior Care Providers Pllc | Internal Medicine | 1910 Aspley Ct, Houston, TX 77094-3431 | 2020-02-22 |
| 1306478730 | Sunny Medical Care Pllc | Internal Medicine | 18220 State Highway 249 Ste 100, Houston, TX 77070-4349 | 2020-02-04 |
| Find all providers in HOUSTON | ||||
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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.