Individual provider Active NPI

Moses Mitchener

  • Peer Specialist
  • Youngsville, NC
National Provider Identifier
1053228320
Registry record updated Aug 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
Practice address
94 Wheaton Ave
Youngsville, NC 27596-8691
Phone
(919) 435-0000
NPI assigned
Aug 25, 2026
Last updated
Aug 25, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X NU Primary

Addresses

Primary practice location

94 Wheaton Ave
Youngsville, NC 27596-8691

Mailing address

PO Box 703
Selma, NC 27576-0703

Other practice location 1

15000 Weston Pkwy Ste 125
Cary, NC 27513-2118
Phone (919) 912-5565

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1787616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787616000000",
    "number": "1053228320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 703",
            "city": "SELMA",
            "state": "NC",
            "postal_code": "275760703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94 WHEATON AVE",
            "city": "YOUNGSVILLE",
            "state": "NC",
            "postal_code": "275968691",
            "telephone_number": "919-435-0000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15000 Weston Pkwy Ste 125",
            "address_purpose": "LOCATION",
            "city": "Cary",
            "state": "NC",
            "postal_code": "275132118",
            "country_code": "US",
            "telephone_number": "919-912-5565",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITCHENER",
        "first_name": "MOSES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-08-25",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngsville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2026; 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.