DR. JIMMY L MOSS


Address: 12634 Olive Blvd Dept Of, Saint Louis, MO 63141-6337
Phone: 8008629980

DR. JIMMY L MOSS (NPI# 1275845208) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1275845208
Entity Type Individual
Full Name DR. JIMMY L MOSS
Credential MD
Practice Address 12634 Olive Blvd Dept Of
Saint Louis
MO 63141-6337
Mailing Address 660 S Euclid Ave
Cb 8054
Saint Louis
MO 63110-1010
Practice Telephone 8008629980
Practice Fax Number 3143621185
Mailing Telephone 6187672459
Mailing Fax Number 6182576759
Enumeration Date 2010-07-07
Last Update Date 2020-08-13
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207RC0200X Internal Medicine
Specialization: Critical Care Medicine
2020009346 MO Allopathic & Osteopathic Physicians
N 207RC0200X Internal Medicine
Specialization: Critical Care Medicine
036143163 IL Allopathic & Osteopathic Physicians

Provider Secondary Practice Location

Address Telephone Number Fax Number
4500 Memorial Dr, Belleville, IL 622265360 6187672459 3142576759

Office Location

Street Address 12634 OLIVE BLVD DEPT OF
City SAINT LOUIS
State MO
Zip Code 63141-6337

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1679102842 Noor Ramadan Pharmacist 628 North New Ballad Road, Suite A, Creve Coeur, MO 63141 2020-04-08
1497381206 Washington University Durable Medical Equipment & Medical Supplies 1044 North Mason Road, Suite 110/210, St. Louis, MO 63141 2020-03-13
1154956498 Ashleigh Clendenny Physician Assistant Mercy Hospital St. Louis, 615 S New Ballas Rd, St. Louis, MO 63141 2020-03-06
1801429410 Emili Lou Haley Registered Nurse 650 Maryville Drive, St Louis, MO 63141 2020-02-21
1629553110 Rebecca Kathleen Pike Social Worker West County Psychological Associates, 12125 Woodcrest Executive Drive #110, St. Louis, MO 63141 2018-10-01
1649756099 River City Sedation Associates, LLC Nurse Anesthetist, Certified Registered 12855 N 40 Dr Ste 150, Saint Louis, MO 63141 2018-07-18
1205333952 Ear Care and Hearing of St. Louis Hearing Aid Equipment 11630 Studt Ave Ste 210, Creve Coeur, MO 63141 2018-04-10
1659897486 Erin Goodman Physical Therapist 10560 Old Olive St. Rd, Suite 100, Creve Coeur, MO 63141 2017-08-14
1093230450 Center for Urologic Surgery LLC Clinic/Center 12855 N 40 Dr Ste 100, Saint Louis, MO 63141 2017-08-07
1871016105 Jacob Farley Tanner Specialist/Technologist 1054 Town and Four Parkway Dr, Creve Coeur, MO 63141 2017-07-19
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Taxonomy Information

Taxonomy Code 207RC0200X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Critical Care Medicine

Taxonomy Definition

An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists.
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.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1871585356 Salvador Lobianco Internal Medicine 11155 Dunn Rd, Ste: 315e, Saint Louis, MO 63136-6150 2005-08-19
1235121013 Nadeem D Parkar Internal Medicine 3635 Vista At Grand, Radiology Dept - Sluh, Saint Louis, MO 63110-0250 2005-08-18
1376546804 Nadeem Ahmed Internal Medicine 777 Craig Rd Ste 130, Saint Louis, MO 63141-7133 2005-05-30
1194255455 Christopher David Coriasso Internal Medicine 625 S New Ballas Rd Ste 7020, Saint Louis, MO 63141-8218 2017-06-19
1669882205 Justin Grady Internal Medicine 615 S New Ballas Rd, Saint Louis, MO 63141-8221 2014-05-05
1760815740 Inpatient Consultants of Missouri Inc Internal Medicine 12125 Woodcrest Executive Dr Ste 220, Saint Louis, MO 63141-5010 2013-08-14
1083977367 Peter Kang Internal Medicine 1 Barnes Jewish Hospital Plz, Saint Louis, MO 63110-1003 2012-06-21
1861758526 Keith Timothy Ferguson Internal Medicine 3660 Vista Ave, Saint Louis, MO 63110-2540 2012-04-06
1013203454 Karthik Iyer Internal Medicine 1100 S Grand Blvd, Drc 831, Saint Louis, MO 63104-1015 2011-06-23
1285954743 Elizabethann Nadine Raitz-cowboy Internal Medicine 999 Executive Parkway Dr Ste 210, Saint Louis, MO 63141-6336 2010-06-08
Find all providers in SAINT LOUIS

Competitor

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City SAINT LOUIS
Zip Code 63141

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Dataset Information

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.

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