DR. JEFFERSON EADDY CARTER MOULDS (NPI# 1265420582) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265420582 |
| Entity Type | Individual |
| Full Name | DR. JEFFERSON EADDY CARTER MOULDS |
| Credential | M.D. |
| Practice Address |
20480 Market Street Onancock VA 23417-0430 |
| Mailing Address |
Po Box 430 Onancock VA 23417-0430 |
| Practice Telephone | 7573022600 |
| Practice Fax Number | 7577890631 |
| Mailing Telephone | (757) 302-2600 |
| Mailing Fax Number | 7577890631 |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2017-08-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085R0001X |
Radiology Specialization: Radiation Oncology |
D50244 | MD | Allopathic & Osteopathic Physicians |
| Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
0101052934 | VA | Allopathic & Osteopathic Physicians |
| N | 2085R0001X |
Radiology Specialization: Radiation Oncology |
21925 | DC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | MAMSI/UNITED HEALTHCARE | 2176156 | 01 |
| VA | ANTHEM BCBS | 342750 | 01 |
| VA | 1265420582 | 05 | |
| VA | CIGNA | 9558847 | 01 |
| Street Address |
20480 MARKET STREET |
| City | ONANCOCK |
| State | VA |
| Zip Code | 23417-0430 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417495367 | Riverside Physician Services Inc | Radiology | 20480 Market Street, Onancock, VA 23417 | 2017-02-10 |
| 1649686429 | Abdallah Abdelrazeq | Internal Medicine | 20480 Market Street, Onancock, VA 23417 | 2014-07-01 |
| 1710218664 | Peninsula Cancer Institute LLC | Internal Medicine | 20480 Market Street, Onancock, VA 23417 | 2010-01-15 |
| 1134453137 | Riverside Physician Services, Inc | Hospitalist | 20480 Market Street, Onancock, VA 23417 | 2009-09-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710593025 | Dawn Alison Craig | Speech-Language Pathologist | 25221 Savageville Road Unit A, Onancock, VA 23417 | 2020-09-22 |
| 1679827687 | James J James | Preventive Medicine | 16422 Wanderers Port Lane, Onancock, VA 23417 | 2012-10-30 |
| 1619076916 | Shore Health Services Inc. | General Acute Care Hospital | 20480 Market St, Onancock, VA 23417 | 2006-09-22 |
| 1952330219 | Bruce Alan Krueger | Podiatrist | 20190 Market St., Onancock, VA 23417 | 2006-06-30 |
| 1639178122 | Michael Grillon | Family Medicine | 20486 Market Street, Onancock, VA 23417 | 2005-07-18 |
| 1821591942 | Sarah Mears Chew | Speech-Language Pathologist | 20486 Market Street, Onancock, VA 23417 | 2018-03-15 |
| 1801334297 | Riverside Physician Services Inc | Family Medicine | 20486 Market Street, Onancock, VA 23417 | 2017-02-06 |
| 1346525128 | Allen Ozeran | Internal Medicine | 20486 Market Street, Onancock, VA 23417 | 2011-10-12 |
| 1366726077 | Rudra Beharrysingh | Internal Medicine | 20480 Market St, Onancock, VA 23417 | 2011-09-30 |
| 1730474115 | Ambar Matta | Surgery | 20486 Market Street, Onancock, VA 23417 | 2011-06-14 |
| Find all providers in zip 23417 | ||||
| Taxonomy Code | 2085R0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Radiation Oncology |
| A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417495367 | Riverside Physician Services Inc | Radiology | 20480 Market Street, Onancock, VA 23417 | 2017-02-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255836953 | Raj Singh | Radiology | Vcu Department of Radiation Oncology, 980058, 1250 E. Marshall Street, Richmond, VA 23298-0058 | 2018-03-26 |
| 1982956678 | Maryview Hospital | Radiology | 7185 Harbour Towne Pkwy S Ste 108, Suffolk, VA 23435-3796 | 2012-10-05 |
| 1578838553 | Commonwealth Oncology Group, LLC | Radiology | 6801 Gov. G. C. Peery Hwy., Clinch Valley Medical Center, Richlands, VA 24641-2194 | 2012-03-09 |
| 1699089953 | Suasin Cancer Care, Inc. | Radiology | 6801 Gov.g.c. Peery Hwy, Richlands, VA 24641 | 2010-07-28 |
| 1760712434 | Ramesh Kakria | Radiology | 1533 Lake James Dr, Virginia Beach, VA 23464-6750 | 2010-01-01 |
| 1649436510 | Camille Williams | Radiology | 6137 Lincolnia Rd, Unit 11182, Alexandria, VA 22312-8000 | 2008-07-31 |
| 1013175769 | Kelli A. Reardon | Radiology | 2871 Ivy Rd, Charlottesville, VA 22903-9304 | 2008-05-29 |
| 1225200132 | Timothy J Harris | Radiology | 401 College Street, Richmond, VA 23298-0058 | 2008-03-31 |
| 1487785564 | Tyvin A. Rich | Radiology | Uva Hospital West, Hospital Drive, 3rd Floor, Charlottesville, VA 22908-0001 | 2007-03-08 |
| 1194866434 | Maria D. Kelly | Radiology | 1230 Grove Park Ct, Earlysville, VA 22936-2840 | 2007-02-09 |
| Find all providers with the same taxonomy | ||||
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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.