Benjamin Glatter Moss, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

809 Pardee LN
Wyncote, PA 19095-1609

Phone

(215) 478-5500

NPI assigned

Aug 30, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1598745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632268800000",
    "number": "1104439942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 PARDEE LN",
            "city": "WYNCOTE",
            "state": "PA",
            "postal_code": "190951609",
            "telephone_number": "215-478-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 PARDEE LN",
            "city": "WYNCOTE",
            "state": "PA",
            "postal_code": "190951609",
            "telephone_number": "215-478-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSS",
        "first_name": "BENJAMIN",
        "middle_name": "GLATTER",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-08-30",
        "last_updated": "2021-09-22",
        "certification_date": "2021-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sonny Misa, OTD
• Nashwa Mohamed, RPH
• Amanda Marie Montgomery, COTA/L
• Saikia Moore, MS
• Yolanda Morris, ED.D
• Ali Mousavi, D.C.
• Vincent Gregory Naughton, OTR/L
• Ruth Nelson
• Cam-Huyen Thi Nguyen, PHARM D.
• Delaney Grace Nichols, MS, CF-SLP

• Athletic Trainer in Wyncote, PA
• Providers in Wyncote, PA by specialty
• Athletic Trainer in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2021; 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.