Organization Active NPI

Fred R Moss MD Inc

  • Psychiatry Physician
  • Carmichael, CA
National Provider Identifier
1033385539
Registry record updated Jul 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
35059484 Issued in OH
Legal business name
FRED R MOSS MD INC
Practice address
3233 California Ave
Carmichael, CA 95608-3934
Phone
(513) 419-9367
Fax
(513) 770-3393
NPI assigned
May 5, 2008
Last updated
Jul 31, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2013

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

Authorized official

Name
Dr. Fred R Moss, MD
Title
President
Phone
(513) 419-9367

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X 35059484 OH Primary

Addresses

Primary practice location

3233 California Ave
Carmichael, CA 95608-3934

Mailing address

3233 California Ave
Carmichael, CA 95608-3934
Phone (513) 419-9367

Other identifiers 1

IdentifierTypeStateIssuer
0827672MedicaidOH

National Provider Directory

National Provider Directory

Locations

5740 Gateway
Ste 101
Mason, OH 45040
Phone (513) 419-9367

NPI Registry JSON

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

{
    "created_epoch": "1209945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375228800000",
    "number": "1033385539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3233 CALIFORNIA AVE",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956083934",
            "telephone_number": "513-419-9367",
            "fax_number": "513-770-3393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3233 CALIFORNIA AVE",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956083934",
            "telephone_number": "513-419-9367",
            "fax_number": "513-770-3393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRED R MOSS MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-05",
        "last_updated": "2013-07-31",
        "status": "A",
        "authorized_official_last_name": "MOSS",
        "authorized_official_first_name": "FRED",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "513-419-9367",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35059484",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0827672",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmichael, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2013; 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.