Individual provider Active NPI

Gina Nicole Moody, DO

  • Internal Medicine Physician
  • Columbus, OH
National Provider Identifier
1033378989
Registry record updated May 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
34-009373 Issued in OH
Practice address
745 W State St
510
Columbus, OH 43222-1515
Phone
(614) 464-0788
Fax
(614) 464-0295
NPI assigned
Jun 5, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 34-009373 OH Primary
Hospitalist Physician 208M00000X 34.009373 OH
Pulmonary Disease Physician 207RP1001X 34009373 OH

Addresses

Primary practice location

745 W State St
510
Columbus, OH 43222-1515

Mailing address

745 W State St
510
Columbus, OH 43222-1515
Phone (614) 464-0788

Other identifiers 3

IdentifierTypeStateIssuer
2932974MedicaidOH
3810019460MedicaidWV
000000706454OtherOHANTHEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090512000674 OH Practitioner - Pulmonary DiseasePractitioner - Internal Medicine 9739238270 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Lake Erie College of Osteopathic Medicine, Erie, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

6150 E Broad St
Columbus, OH 43213-1574
Phone (614) 546-4400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.44 of 100Reported as group
Quality
75.57
Promoting interoperability
79
Improvement activities
40
Cost
73.41

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
34-009373OHMDInternal Medicine Physician
34.009373OHMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Carmel Healthproviders Two LLC CurrentSince Aug 11, 2014 Accepting new patients
Mount Carmel Healthproviders Two LLC CurrentSince Aug 11, 2014 Accepting new patients

Locations

7901 Diley Rd
Ste 205
Canal Winchester, OH 43110
Phone (614) 464-0788

6150 E Broad St
Columbus, OH 43213
Phone (614) 546-4400

745 W State St
#510
Columbus, OH 43222
Phone (614) 464-0788

6150 E Broad St
Rm WD210
Columbus, OH 43213

745 W State St
Ste 510
Columbus, OH 43222
Phone (614) 464-0788

210 N Main St
London, OH 43140
Phone (740) 845-7343

Interoperability endpoints

  • Direct secure messaging: gmoody1148006@direct.trinity-health.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1212624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368403200000",
    "number": "1033378989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "745 W STATE ST",
            "address_2": "510",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432221515",
            "telephone_number": "614-464-0788",
            "fax_number": "614-464-0295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 W STATE ST",
            "address_2": "510",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432221515",
            "telephone_number": "614-464-0788",
            "fax_number": "614-464-0295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOODY",
        "first_name": "GINA",
        "middle_name": "NICOLE",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-05",
        "last_updated": "2013-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "34-009373",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OH",
            "license": "34.009373",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "OH",
            "license": "34009373",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2932974",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810019460",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000706454",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.