NPIMap

Individual provider Active NPI

Alfred Randall Moss, MD

  • Adult Medicine Physician
  • Gaffney, SC
National Provider Identifier
1245294107
Registry record updated Sep 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
009903 Issued in SC
Practice address
101 Professional Park
Gaffney, SC 29340-2319
Phone
(864) 489-1446
Fax
(864) 489-4909
NPI assigned
Apr 17, 2006
Last updated
Sep 28, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X 009903 SC Primary

Addresses

Primary practice location

101 Professional Park
Gaffney, SC 29340-2319

Mailing address

101 Professional Park
Gaffney, SC 29340-2319
Phone (864) 489-1446

Other identifiers 1

IdentifierTypeStateIssuer
PC3331MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050111000411 SC Practitioner - Family Practice 6901718105 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical University of South Carolina College of Medicine, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alfred Randall Moss, M.D. P.aGroup PAC ID 3173436052, 3 clinicians

Practice addresses (Care Compare)

101 Professional Park
Gaffney, SC 29340-2319
Phone (864) 489-1446

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
009903SCMDAdult Medicine Physician
9903SCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Alfred Randall Moss MD PA Adult Medicine CurrentSince Jan 1, 1984 Accepting new patients
Alfred Randall Moss MD PA Current Accepting new patients
Carolina Physical Medicine and Past Accepting new patients
Moss Enterprise PastSince Sep 27, 2015 Accepting new patients

Locations

101 Professional Park
Gaffney, SC 29340
Phone (864) 487-5516

101 Professional Park
#C
Gaffney, SC 29340
Phone (864) 489-1446

101 Professional Park
#D
Gaffney, SC 29340
Phone (864) 649-1050

101 Professional Park
#B
Gaffney, SC 29340
Phone (864) 487-5516

101 Professional Park
Ste D
Gaffney, SC 29340
Phone (864) 206-0410

Organizations & group practices 5

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317168000000",
    "number": "1245294107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 PROFESSIONAL PARK",
            "city": "GAFFNEY",
            "state": "SC",
            "postal_code": "293402319",
            "telephone_number": "864-489-1446",
            "fax_number": "864-489-4909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 PROFESSIONAL PARK",
            "city": "GAFFNEY",
            "state": "SC",
            "postal_code": "293402319",
            "telephone_number": "864-489-1446",
            "fax_number": "864-489-4909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSS",
        "first_name": "ALFRED",
        "middle_name": "RANDALL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-17",
        "last_updated": "2011-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "SC",
            "license": "009903",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PC3331",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gaffney, SC

Sources for this page

Verify at the official NPI Registry.