Individual provider Active NPI

Cornelius N Mosby

  • Behavior Analyst
  • Southaven, MS
National Provider Identifier
1053243634
Registry record updated May 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
800017538 Issued in MS
Practice address
1725 Dorchester Dr Apt 6L
Southaven, MS 38671-5724
Phone
(662) 996-6735
NPI assigned
May 30, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X 800017538 MS Primary

Addresses

Primary practice location

1725 Dorchester Dr Apt 6L
Southaven, MS 38671-5724

Mailing address

1725 Dorchester Dr Apt 6L
Southaven, MS 38671-5724
Phone (662) 996-6735

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

State licenses

LicenseStateTypeSpecialty
800017538MSMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1780099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780099200000",
    "number": "1053243634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 DORCHESTER DR APT 6L",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386715724",
            "telephone_number": "662-996-6735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 DORCHESTER DR APT 6L",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386715724",
            "telephone_number": "662-996-6735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSBY",
        "first_name": "CORNELIUS",
        "middle_name": "N",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-05-30",
        "last_updated": "2026-05-30",
        "certification_date": "2026-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": "MS",
            "license": "800017538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southaven, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 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.