Active NPI
Andrew Moss, PTA
- Physical Therapy Assistant
- Crossville, TN
National Provider Identifier
1104474170
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 7145
- Practice address
- 115 Cumberland PLZ
Crossville, TN 38555-4292 - Phone
- (931) 787-1244
- Fax
- (931) 787-1245
- NPI assigned
- Sep 3, 2019
- 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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 7145 | TN | Primary |
Addresses
Primary practice location
115 Cumberland PLZ
Crossville, TN 38555-4292
Mailing address
1200 Corporate Dr Ste 400
Birmingham, AL 35242-5424
Phone (423) 238-8930
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7145 | TN | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1567468800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1567468800000",
"number": "1104474170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 CORPORATE DR STE 400",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352425424",
"telephone_number": "423-238-8930"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 CUMBERLAND PLZ",
"city": "CROSSVILLE",
"state": "TN",
"postal_code": "385554292",
"telephone_number": "931-787-1244",
"fax_number": "931-787-1245"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOSS",
"first_name": "ANDREW",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-09-03",
"last_updated": "2019-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "TN",
"license": "7145",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Crossville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.