Active NPI
Randy K Moss, PH.D.
- Counseling Psychologist
- Kaysville, UT
National Provider Identifier
1134586654
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- Practice address
- 447 N 300 W
Kaysville, UT 84037-4203 - Phone
- (907) 232-5374
- Fax
- (801) 544-3819
- NPI assigned
- Jan 28, 2016
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Psychologist | 103TA0400X | |||
| Cognitive & Behavioral Psychologist | 103TB0200X | |||
| Counseling Psychologist | 103TC1900X | Primary |
Addresses
Primary practice location
447 N 300 W
Kaysville, UT 84037-4203
Mailing address
4589 Ranch Blvd
Mountain Green, UT 84050-5515
Phone (907) 232-5374
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
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1453939200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1453939200000",
"number": "1134586654",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4589 RANCH BLVD",
"city": "MOUNTAIN GREEN",
"state": "UT",
"postal_code": "840505515",
"telephone_number": "907-232-5374",
"fax_number": "801-544-3819"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "447 N 300 W",
"city": "KAYSVILLE",
"state": "UT",
"postal_code": "840374203",
"telephone_number": "907-232-5374",
"fax_number": "801-544-3819"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOSS",
"first_name": "RANDY",
"middle_name": "K",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-01-28",
"last_updated": "2016-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "103TA0400X",
"taxonomy_group": "",
"desc": "Psychologist, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Kaysville, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.