Individual provider Active NPI

Jeff Allen Moody, PSY.D.

  • Psychologist
  • Newberg, OR
National Provider Identifier
1093882599
Registry record updated Feb 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
3007 Issued in OR
Practice address
307 E 2ND St Ste 250
Newberg, OR 97132-3077
Phone
(405) 620-3508
NPI assigned
Nov 29, 2006
Last updated
Feb 10, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 3007 OR Primary

Addresses

Primary practice location

307 E 2ND St Ste 250
Newberg, OR 97132-3077

Mailing address

307 E 2ND St Ste 250
Newberg, OR 97132-3077
Phone (405) 620-3508

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190827001062 OR Practitioner - Clinical Psychologist 0345578555

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

307 E 2ND St
Suite 250
Newberg, OR 97132-3077

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3007ORMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Integrative Clinical Psychology, PLLC CurrentSince Jul 28, 2024 Accepting new patients
Jeff Moody, LLC CurrentSince Jun 8, 2019 Accepting new patients
Jeff a. Moody, PLLC Marriage & Family Therapist Past Accepting new patients

Locations

307 E 2nd St
Ste 250
Newberg, OR 97132
Phone (971) 832-8550

1101 Waters Edge Dr
Ste 108
Granbury, TX 76048
Phone (817) 559-1754

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, 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": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739145600000",
    "number": "1093882599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 E 2ND ST STE 250",
            "city": "NEWBERG",
            "state": "OR",
            "postal_code": "971323077",
            "telephone_number": "405-620-3508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 E 2ND ST STE 250",
            "city": "NEWBERG",
            "state": "OR",
            "postal_code": "971323077",
            "telephone_number": "405-620-3508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOODY",
        "first_name": "JEFF",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OR",
            "license": "3007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newberg, OR

Sources for this page

Verify at the official NPI Registry.