Active NPI
Randy C Moze, D.C.
- Rehabilitation Chiropractor
- Johnson City, TN
National Provider Identifier
1093888976
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Chiropractor
- License
- 2216
- Practice address
- 1617 W Market St Ste a
Johnson City, TN 37604-4903 - Phone
- (423) 975-0099
- Fax
- (423) 975-0996
- NPI assigned
- Nov 16, 2006
- 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 |
|---|---|---|---|---|
| Rehabilitation Chiropractor | 111NR0400X | 2216 | TN | Primary |
Addresses
Primary practice location
1617 W Market St Ste a
Johnson City, TN 37604-4903
Mailing address
PO Box 3563
Johnson City, TN 37602-3563
Phone (423) 975-0099
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6409 | GA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323129600000",
"number": "1093888976",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3563",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376023563",
"telephone_number": "423-975-0099",
"fax_number": "423-975-0996"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1617 W MARKET ST STE A",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376044903",
"telephone_number": "423-975-0099",
"fax_number": "423-975-0996"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOZE",
"first_name": "RANDY",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-16",
"last_updated": "2011-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "111NR0400X",
"taxonomy_group": "",
"desc": "Chiropractor, Rehabilitation",
"state": "TN",
"license": "2216",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Johnson City, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.