Derick W Moody, PA

Primary specialty

Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X

License

8820342-1206 Issued in UT

Practice address

672 W 400 S Ste 201
Springville, UT 84663-3170

Phone

(801) 369-8989

Fax

(801) 704-9741

NPI assigned

Jan 7, 2014

Last updated

Sep 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Numinus Wellness Ut IncGroup PAC ID 2163750688, 50 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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

• Numinus Wellness Ut Inc

  • Psychiatry Physician
  • Springville, UT
  • NPI 1265092282
  Medicare reassignment Care Compare group
• Ascent Mental Health PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Payson, UT
  • NPI 1912636374
  NPD (past)
• Jason B Dickerson DPM LC

  dba Utah Bone and Joint Specialists

  • Foot & Ankle Surgery Podiatrist
  • Murray, UT
  • NPI 1164925467
  NPD (past)
• Ogden Internal Medicine & Urology LLC

  • Internal Medicine Physician
  • Ogden, UT
  • NPI 1003001553
  NPD (past)
• Revere Health PC

  dba Revere Health

  • Multi-Specialty Clinic/Center
  • Spanish Fork, UT
  • NPI 1851142285
  NPD (past)

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

{
    "created_epoch": "1389052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1235551409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "672 W 400 S",
            "address_2": "STE 201",
            "city": "SPRINGVILLE",
            "state": "UT",
            "postal_code": "846633170",
            "telephone_number": "801-812-4673",
            "fax_number": "801-418-0941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "672 W 400 S STE 201",
            "city": "SPRINGVILLE",
            "state": "UT",
            "postal_code": "846633170",
            "telephone_number": "801-369-8989",
            "fax_number": "801-704-9741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOODY",
        "first_name": "DERICK",
        "middle_name": "W",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-01-07",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "8820342-1206",
            "primary": false
        },
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "UT",
            "license": "8820342-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cheryl A Minor, C.D.
• Charity Mitchell
• Steven Mohlman, DPT
• Derek Monahan
• Monica L. Blume, LCSW, LLC (The Center for Hope)
• Kristen Morgan, CSW
• Saralynn Morgan, RN
• Kathryn Conover Morrill, FNP
• Hanann Morris
• Maxwell Marshall Mount, LCSW

• Psychiatric/Mental Health Clinical Nurse Specialist in Springville, UT
• Providers in Springville, UT by specialty
• Psychiatric/Mental Health Clinical Nurse Specialist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.