DR. WILLIS ELVIS MOODY III (NPI# 1497736664) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497736664 |
| Entity Type | Individual |
| Full Name | DR. WILLIS ELVIS MOODY III |
| Credential | M.D. |
| Practice Address |
37 Hospital Way Building 9, Suite B Blairsville GA 30512-3144 |
| Mailing Address |
37 Hospital Way Bldg 9 Suite B Blairsville GA 30512-3144 |
| Practice Telephone | 7067816950 |
| Practice Fax Number | 7067816955 |
| Mailing Telephone | 7067816950 |
| Mailing Fax Number | 7067816955 |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2012-09-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 058708 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | TAX ID | 20-5788381 | 01 |
| GA | GROUP IDENTIFIER | GRP8005 | 01 |
| GA | GROUP NPI | 1487774261 | 01 |
| GA | WELLCARE | 386024 | 01 |
| GA | MEDICAID | 000570534D | 01 |
| GA | 839014891 | 05 |
| Street Address |
37 HOSPITAL WAY BUILDING 9, SUITE B |
| City | BLAIRSVILLE |
| State | GA |
| Zip Code | 30512-3144 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487774261 | Georgia Mountain Surgical Associates | Specialist | 37 Hospital Way, Suite B Building 9, Blairsville, GA 30512-3128 | 2007-03-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003456229 | Southeast Eye Group LLC | Optometrist | 17 Hometown Way, Blairsville, GA 30512 | 2020-01-15 |
| 1902395247 | Pamela Jones | Pharmacist | 207 Highway 515, Blairsville, GA 30512 | 2018-05-02 |
| 1780095851 | Joshua R Kennedy | Pediatrics | 77 Weaver Rd Ste B, Blairsville, GA 30512 | 2014-05-12 |
| 1659634889 | Amy Kight | Occupational Therapist | 383 Fox Flds, Blairsville, GA 30512 | 2012-06-22 |
| 1184986846 | Blair House Dental, LLC | Dentist | 10 Deer Crossing Tr., Blairsville, GA 30512 | 2012-06-08 |
| 1215221718 | Connie Duncan | Hearing Instrument Specialist | 281c Young Harris Street, Blairsville, GA 30512 | 2011-06-02 |
| 1407154727 | Georgia Mountains Community Services | Day Training, Developmentally Disabled Services | 10 B Hughes St, Blairsville, GA 30512 | 2011-03-10 |
| 1114228558 | Ingles Markets Inc | Pharmacy | 207b Highway 515, Blairsville, GA 30512 | 2010-11-16 |
| 1720300569 | Steven H. Senart | Chiropractor | 215 Blue Ridge Street, Suite E, Blairsville, GA 30512 | 2010-02-22 |
| 1649407552 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 2257 Hwy 515, Blairsville, GA 30512 | 2009-06-18 |
| Find all providers in zip 30512 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| 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 Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912180217 | Appalachian Surgical Practice, P.C. | Surgery | 37 Hospital Way Building 9, Suite B, Blairsville, GA 30512-3144 | 2007-12-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043824857 | Oasis Surgical Assistants LLC | Surgery | 170 Blackberry Run Dr, Dallas, GA 30132-1174 | 2020-08-31 |
| 1205440054 | Physician Assistant Surgical Solutions | Surgery | 4290 Bells Ferry Road, Suite 134 - 1032, Kennesaw, GA 30144 | 2020-08-31 |
| 1568087260 | Anthony George Campbell | Surgery | 1475 Laney Walker Blvd, Augusta, GA 30912-0002 | 2020-06-09 |
| 1821613431 | America Stephanie Revere | Surgery | Augusta University Medical Center 1120 15th St, Augusta, GA 30912-0001 | 2020-06-09 |
| 1124653456 | Oasis Surgical Associates LLC | Surgery | 800 Kennesaw Ave Nw Ste 130, Marietta, GA 30060-1052 | 2020-03-06 |
| 1063054237 | Stacey M Lowe | Surgery | 146 Wesleyan Way, Macon, GA 31210-4400 | 2019-10-09 |
| 1356982730 | Quinones & Sanchez LLC | Surgery | 1215 Eagles Landing Pkwy Ste 105, Stockbridge, GA 30281-5084 | 2019-10-07 |
| 1891342135 | Chakita Miesha Allen | Surgery | 24 Halyard Dr, Port Wentworth, GA 31407-9755 | 2019-08-21 |
| 1720631088 | 5am P.C. | Surgery | 475 Hansell St Se, Cairo, GA 39828-3071 | 2019-07-16 |
| 1033779152 | Kathryne Holmes | Surgery | 1120 15th St Rm Bi4076, Augusta, GA 30912-0004 | 2019-06-20 |
| Find all providers with the same taxonomy | ||||
| City | BLAIRSVILLE |
| Zip Code | 30512 |
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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.