Active NPI
Anessa Rae Moody
- Optician
- Centerville, OH
National Provider Identifier
1205534138
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- OP016963.S
- Practice address
- 6244 Wilmington Pike
Centerville, OH 45459-7024 - Phone
- (937) 848-2243
- Fax
- (937) 848-2498
- NPI assigned
- Feb 20, 2023
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Optician | 156FX1800X | OP016963.S | OH | Primary |
Addresses
Primary practice location
6244 Wilmington Pike
Centerville, OH 45459-7024
Mailing address
6244 Wilmington Pike
Centerville, OH 45459-7024
Phone (937) 848-2243
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 |
|---|---|---|---|
| OP016963.S | OH | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1676851200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676851200000",
"number": "1205534138",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6244 WILMINGTON PIKE",
"city": "CENTERVILLE",
"state": "OH",
"postal_code": "454597024",
"telephone_number": "937-848-2243",
"fax_number": "937-848-2498"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6244 WILMINGTON PIKE",
"city": "CENTERVILLE",
"state": "OH",
"postal_code": "454597024",
"telephone_number": "937-848-2243",
"fax_number": "937-848-2498"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOODY",
"first_name": "ANESSA",
"middle_name": "RAE",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-02-20",
"last_updated": "2023-02-20",
"certification_date": "2023-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "OH",
"license": "OP016963.S",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Centerville, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.