Individual provider Active NPI

William Joel Moss, M.D.

  • Obstetrics & Gynecology Physician
  • Chattanooga, TN
National Provider Identifier
1053403550
Registry record updated Mar 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MD0000007472 Issued in TN
Practice address
1755 Gunbarrel Rd
Suite 205
Chattanooga, TN 37421-7137
Phone
(423) 756-0863
Fax
(706) 937-2377
NPI assigned
Sep 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MD0000007472 TN Primary

Addresses

Primary practice location

1755 Gunbarrel Rd
Suite 205
Chattanooga, TN 37421-7137

Mailing address

PO Box 21592
Chattanooga, TN 37424-0592
Phone (423) 756-0863

Other identifiers 1

IdentifierTypeStateIssuer
3716358MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20041213000292 TN Practitioner - Obstetrics/Gynecology 9830156702 Practice locations: Chattanooga, TN
I20050104000301 GA Practitioner - Obstetrics/Gynecology 9830156702 Reassigns benefits to 1 organization
Practice locations: Ringgold, GA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD0000007472TNMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. William J. Moss Obstetrics & Gynecology CurrentSince Oct 14, 2017 Accepting new patients

Locations

1755 Gunbarrel Rd
Ste 205
Chattanooga, TN 37421
Phone (423) 756-0863

6845 Mountain View Rd
Ooltewah, TN 37363
Phone (423) 910-0896

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584057600000",
    "number": "1053403550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21592",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374240592",
            "telephone_number": "423-756-0863",
            "fax_number": "706-937-2377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1755 GUNBARREL RD",
            "address_2": "SUITE 205",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374217137",
            "telephone_number": "423-756-0863",
            "fax_number": "706-937-2377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSS",
        "first_name": "WILLIAM",
        "middle_name": "JOEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2020-03-13",
        "certification_date": "2020-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TN",
            "license": "MD0000007472",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3716358",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.