Individual provider Active NPI

William F B Moorman, MD

  • Dermatology Physician
  • Athens, GA
National Provider Identifier
1194893941
Registry record updated Oct 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
030351 Issued in GA
Practice address
950 Prince Ave
Athens Area Dermatology
Athens, GA 30606
Phone
(706) 369-7546
Fax
(706) 369-6788
NPI assigned
Dec 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 030351 GA Primary

Addresses

Primary practice location

950 Prince Ave
Athens Area Dermatology
Athens, GA 30606

Mailing address

PO Box 168
Athens, GA 30603
Phone (706) 369-7546

Other identifiers 1

IdentifierTypeStateIssuer
00369872GMedicaidGA

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. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
030351GAMDDermatology Physician

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223424000000",
    "number": "1194893941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 168",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "30603",
            "telephone_number": "706-369-7546",
            "fax_number": "706-369-6788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 PRINCE AVE",
            "address_2": "ATHENS AREA DERMATOLOGY",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "30606",
            "telephone_number": "706-369-7546",
            "fax_number": "706-369-6788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORMAN",
        "first_name": "WILLIAM",
        "middle_name": "F B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2008-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "GA",
            "license": "030351",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00369872G",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2008; 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.