MICHAEL SHANNON MOODY (NPI# 1952466583) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952466583 |
| Entity Type | Individual |
| Full Name | MICHAEL SHANNON MOODY |
| Credential | MD |
| Practice Address |
8464 Adair Sreet Douglasville GA 30134-1877 |
| Mailing Address |
8464 Adair St Douglasville GA 30134-1839 |
| Practice Telephone | 7709499804 |
| Practice Fax Number | 7709499842 |
| Mailing Telephone | 7709499804 |
| Mailing Fax Number | 7709499842 |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2020-04-22 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 037626 | GA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760739825 | Michael S Moody | Dentist | 6200 N Durango Dr Ste 100, Las Vegas, NV 89149 | 2012-08-08 |
| 1033204094 | Michael Derrick Moody | Oral & Maxillofacial Surgery | 9990 W 26th Ave, Suite 100, Lakewood, CO 80215-1581 | 2006-10-04 |
| 1649652538 | Michael Moody | Pharmacist | 2301 Holmes St, Kansas City, MO 64108-2640 | 2015-06-26 |
| 1871890368 | Michael D Moody | Nurse Anesthetist, Certified Registered | 1444 Peterman Dr, Alexandria, LA 71301-3432 | 2011-02-17 |
| 1437180783 | Michael Anthony Moody | Pediatrics | 4101 N Roxboro St, Durham, NC 27704-2121 | 2006-07-05 |
| 1063489821 | Michael N Moody | General Practice | 507 N Main St, Salem, AR 72576-9449 | 2006-03-01 |
| Street Address |
8464 ADAIR SREET |
| City | DOUGLASVILLE |
| State | GA |
| Zip Code | 30134-1877 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851915631 | Lilian Pereira | Nurse Practitioner | Bethesda Medical Group, LLC, 9280 Hwy 5 - Suite D, Douglasville, GA 30134 | 2020-06-08 |
| 1548822901 | Sweet Resolve LLC | Nurse Practitioner | 4318 Ridge Rd, Ste 111 Pmb 1017, Douglasville, GA 30134 | 2019-07-05 |
| 1598328791 | Straight Street Life Center Inc | Case Manager/Care Coordinator | 12461 Veterans Memorial, Douglasville, GA 30134 | 2019-04-15 |
| 1174014930 | Caitlin Waldrip | Chiropractor | 8326a Office Park Dr., Douglasville, GA 30134 | 2018-05-28 |
| 1861901050 | Michelle Denise Winston | Licensed Practical Nurse | 6497 E Strickland, Douglasville, GA 30134 | 2017-09-20 |
| 1518335843 | Willis Anthony Rogers | Durable Medical Equipment & Medical Supplies | 7094 Rose Lake Circle, Douglasville, GA 30134 | 2015-09-03 |
| 1497135131 | Patricia Warren | Social Worker | 8317 Office Park Drive Ste.#e, Douglasville, GA 30134 | 2015-06-08 |
| 1457747321 | Kidz Rock Therapy Services, LLC | Occupational Therapist | 6732 West Spring Street, Douglasville, GA 30134 | 2015-04-08 |
| 1386068476 | Naa Y Oden | Psychologist | 4813 Ridge Rd Ste 111-639, Douglasville, GA 30134 | 2014-02-10 |
| 1467893271 | American Ems | Ambulance | 7240 Bankhead Hwy, Douglasville, GA 30134 | 2013-07-09 |
| Find all providers in zip 30134 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427201797 | Atlantic Health Solutions, Inc. | Family Medicine | 6128 Prestley Mill Rd Ste G, Douglasville, GA 30134-5622 | 2008-10-30 |
| 1609031657 | Nakato B. Kibuyaga-travis | Family Medicine | 6043 Prestley Mill Rd Ste B, Douglasville, GA 30134-2280 | 2008-07-18 |
| 1437343563 | Physicians Immediate Med of Douglasville, P.C. | Family Medicine | 9390 The Landing Drive, Douglasville, GA 30135 | 2007-08-31 |
| 1750422242 | Clark Robinson, M.d.,p.c. | Family Medicine | 6671 Church St, Douglasville, GA 30134-1715 | 2007-02-09 |
| 1528128162 | Vance W Boddy | Family Medicine | 6084 Professional Pkwy Ste C, Douglasville, GA 30134-5612 | 2006-12-12 |
| 1164592846 | Veeni S Kumar | Family Medicine | 3327 Highway 5, Douglasville, GA 30135-2307 | 2006-11-09 |
| 1215945969 | Dingane Baruti | Family Medicine | 6842 Douglas Blvd Ste K, Douglasville, GA 30135 | 2006-08-04 |
| 1326053042 | Tmc Total Care Family Medicine Inc | Family Medicine | 8464 Adair St, Suite B, Douglasville, GA 30134-1877 | 2006-07-30 |
| 1578583035 | Hope Hamlin Mcdaniel-desarmes | Family Medicine | 6875 Douglas Blvd, Suite, Kaiser Permanente Douglasville Medical Office, Douglasville, GA 30135 | 2006-07-20 |
| 1508890401 | Tammy Jane Robinson | Family Medicine | 6559 Church St, Douglasville, GA 30134 | 2006-07-10 |
| Find all providers in DOUGLASVILLE | ||||
| City | DOUGLASVILLE |
| Zip Code | 30134 |
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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.