NPIMap

Organization Active NPI

Healthsource of Moses Lake

  • Clinic/Center
  • Moses Lake, WA
National Provider Identifier
1003212895
Registry record updated Nov 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
CH00003167 Issued in WA
Legal business name
HEALTHSOURCE OF MOSES LAKE
Practice address
420 W 3Rd Ave
Moses Lake, WA 98837-1908
Phone
(509) 765-0638
Fax
(509) 765-3891
NPI assigned
Nov 6, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Gregg Moyle Jones, D.C.NPI 1598852840
Title
President
Phone
(509) 765-0638

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X CH00003167 WA Primary

Addresses

Primary practice location

420 W 3Rd Ave
Moses Lake, WA 98837-1908

Mailing address

420 W 3Rd Ave
Moses Lake, WA 98837-1908
Phone (509) 765-0638

National Provider Directory

National Provider Directory

Locations

420 W 3rd Ave
Moses Lake, WA 98837
Phone (509) 765-0638

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1415232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415232000000",
    "number": "1003212895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 W 3RD AVE",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988371908",
            "telephone_number": "509-765-0638",
            "fax_number": "509-765-3891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 W 3RD AVE",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988371908",
            "telephone_number": "509-765-0638",
            "fax_number": "509-765-3891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHSOURCE OF MOSES LAKE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-06",
        "last_updated": "2014-11-06",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "GREGG",
        "authorized_official_middle_name": "MOYLE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "509-765-0638",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "WA",
            "license": "CH00003167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moses Lake, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.