Jennifer M Moss

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

K7835 Issued in TX

Legal business name

JENNIFER M MOSS

Doing business as

Concho Valley OB-GYN

Practice address

3019 Green Meadow Dr
San Angelo, TX 76904-6975

Phone

(325) 944-9999

Fax

(325) 944-9996

NPI assigned

Apr 22, 2015

Last updated

Sep 29, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jennifer Michele Moss, M.D.

Title

Sole Proprietor

Phone

(325) 944-9999

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Concho Valley OB-GYN Doing business as

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

{
    "created_epoch": "1429660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443484800000",
    "number": "1164819603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3019 GREEN MEADOW DR",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769046975",
            "telephone_number": "325-944-9999",
            "fax_number": "325-944-9996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3019 GREEN MEADOW DR",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769046975",
            "telephone_number": "325-944-9999",
            "fax_number": "325-944-9996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNIFER M MOSS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-22",
        "last_updated": "2015-09-29",
        "status": "A",
        "authorized_official_last_name": "MOSS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "MICHELE",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "325-944-9999",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "TX",
            "license": "K7835",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1508019993",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Concho Valley OB-GYN",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Yolanda Balderas Jasso
• Kenneth M Jastrow III, M.D
• Carol J Jeffers, LPC MASTERS DEGREE
• Joe Mac Jeffers, ED.D.
• Jose Jenks, PHARMD
• Jason Damian Jensen
• Thomas S Jeter, MD, DDS
• Tresea M Jeter, FNP-C
• Joshua Jibben, LCDC-I
• Jim Dandy Medical Inc

• Medical Specialty Clinic/Center in San Angelo, TX
• Providers in San Angelo, TX by specialty
• Medical Specialty Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2015; 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.