Active NPI
Aaron M Moredock, PAC
- Physician Assistant
- Nashville, TN
National Provider Identifier
1063416436
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 855
- Practice address
- 2000 Church Street
Emergency Dept
Nashville, TN 37236 - Phone
- (615) 284-8484
- Fax
- (615) 284-3854
- NPI assigned
- Jun 13, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 855 | TN | Primary |
Addresses
Primary practice location
2000 Church Street
Emergency Dept
Nashville, TN 37236
Mailing address
One Vantage Way
Suite B 240
Nashville, TN 37228
Phone (615) 329-4020
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 855 | TN | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medical Observation Services LLC | Past | Accepting new patients | |
| Volunteer Medical Group, P.C. | Past | Accepting new patients |
Organizations & group practices 4
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.
-
- Emergency Medicine Physician
- Nashville, TN
- NPI 1720785884
-
- Emergency Medicine Physician
- Nashville, TN
- NPI 1194758979
-
- Emergency Medicine Physician
- Cookeville, TN
- NPI 1669734877
-
- Emergency Medicine Physician
- Cookeville, TN
- NPI 1801886999
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1063416436",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "ONE VANTAGE WAY",
"address_2": "SUITE B 240",
"city": "NASHVILLE",
"state": "TN",
"postal_code": "37228",
"telephone_number": "615-329-4020",
"fax_number": "615-329-9479"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2000 CHURCH STREET",
"address_2": "EMERGENCY DEPT",
"city": "NASHVILLE",
"state": "TN",
"postal_code": "37236",
"telephone_number": "615-284-8484",
"fax_number": "615-284-3854"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOREDOCK",
"first_name": "AARON",
"middle_name": "M",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-13",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TN",
"license": "855",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Nashville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.