Individual provider Active NPI

David R Moss, M.D.

  • Psychiatry Physician
  • Jacksonville, FL
National Provider Identifier
1144511700
Registry record updated Mar 4, 2013
On this page

OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

  • Section 1128b(4) exclusion effective Oct 19, 2017.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
ME45122 Issued in FL
Practice address
1200 Riverplace Blvd
Suite: 620
Jacksonville, FL 32207-9046
Phone
(904) 396-6620
Fax
(904) 396-6528
NPI assigned
Apr 29, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X ME0045122 FL
Psychiatry Physician 2084P0800X ME45122 FL Primary

Addresses

Primary practice location

1200 Riverplace Blvd
Suite: 620
Jacksonville, FL 32207-9046

Mailing address

1200 Riverplace Blvd
Suite: 620
Jacksonville, FL 32207-9046
Phone (904) 396-6620

Other identifiers 6

IdentifierTypeStateIssuer
6609848OtherFLAETNA CHOICE POS
2164947OtherFLCIGNA
260335700MedicaidFL
27356163700OtherOHOHIO BUREAU OF WORKERS COMPENSATION
694322OtherFLVALUE OPTIONS
N614194OtherFLWELLCARE

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Consultants of Florida, Inc Psychiatry Past Accepting new patients
Tracy Riley Counseling LLC PastSince Dec 8, 2024 Accepting new patients
Southeastern Neuroscience Institute PA Specialist Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1304035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362355200000",
    "number": "1144511700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 RIVERPLACE BLVD",
            "address_2": "SUITE: 620",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322079046",
            "telephone_number": "904-396-6620",
            "fax_number": "904-396-6528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 RIVERPLACE BLVD",
            "address_2": "SUITE: 620",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322079046",
            "telephone_number": "904-396-6620",
            "fax_number": "904-396-6528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSS",
        "first_name": "DAVID",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-29",
        "last_updated": "2013-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME0045122",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME45122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA CHOICE POS",
            "identifier": "6609848",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2164947",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "260335700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO BUREAU OF WORKERS COMPENSATION",
            "identifier": "27356163700",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "694322",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "N614194",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.