NPIMap

Individual provider Active NPI

Carol Clark Moses, FNP

  • Family Nurse Practitioner
  • Greenwood, MS
National Provider Identifier
1245892777
Registry record updated Jul 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
903410 Issued in MS
Practice address
1401 River Rd
Greenwood, MS 38930-4030
Phone
(662) 459-7000
Fax
(662) 459-1310
NPI assigned
Jul 4, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 903410 MS Primary

Addresses

Primary practice location

1401 River Rd
Greenwood, MS 38930-4030

Mailing address

PO Box 1410
Greenwood, MS 38935-1410
Phone (662) 453-7000

Other practice location 1

1601 Strong Ave
Greenwood, MS 38930-4037
Phone (662) 451-7565

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20200103000420 MS Practitioner - Nurse Practitioner 0345674123 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Sunflower Medical CenterGroup PAC ID 7618932294, shared by 11 NPIs, 46 clinicians

Practice addresses (Care Compare)

840 N Oak Ave
Ruleville, MS 38771-3227
Phone (601) 756-2711

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
903410MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Sunflower Medical Center Current Accepting new patients
Sunder Jagwani MD PA Current Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Sep 18, 2019 Accepting new patients
North Sunflower Medical Center Current Accepting new patients
North Sunflower Medical Center CurrentSince Nov 15, 2023 Accepting new patients
Greenwood Leflore Hospital CurrentSince Sep 18, 2019 Accepting new patients
North Sunflower Medical Center CurrentSince Nov 15, 2023 Accepting new patients
Central Mississippi Radiology Current Accepting new patients
North Sunflower Medical Center CurrentSince Nov 15, 2023 Accepting new patients

Locations

1601 Strong Ave
Greenwood, MS 38930
Phone (662) 451-7565

1401 River Rd
Greenwood, MS 38930
Phone (662) 459-2603

840 N Oak Ave
Ruleville, MS 38771
Phone (601) 756-2711

Interoperability endpoints

  • Direct secure messaging: carol.moses.p1@direct.glh.nextgenshare.com

Organizations & group practices 9

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

Hospital & facility affiliations 3

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": "1562198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562198400000",
    "number": "1245892777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1410",
            "city": "GREENWOOD",
            "state": "MS",
            "postal_code": "389351410",
            "telephone_number": "662-453-7000",
            "fax_number": "662-459-1310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 RIVER RD",
            "city": "GREENWOOD",
            "state": "MS",
            "postal_code": "389304030",
            "telephone_number": "662-459-7000",
            "fax_number": "662-459-1310"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1601 Strong Ave",
            "address_purpose": "LOCATION",
            "city": "Greenwood",
            "state": "MS",
            "postal_code": "389304037",
            "country_code": "US",
            "telephone_number": "662-451-7565",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOSES",
        "first_name": "CAROL",
        "middle_name": "CLARK",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-04",
        "last_updated": "2019-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "903410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, MS

Sources for this page

Verify at the official NPI Registry.