Individual provider Active NPI

Thomas E Moody, M.D.

  • Addiction Medicine (Family Medicine) Physician
  • Homewood, AL
National Provider Identifier
1265405039
Registry record updated Feb 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X
License
7582 Issued in AL
Practice address
3485 Independence Dr
Homewood, AL 35209-5603
Phone
(205) 930-0920
Fax
(205) 445-0115
NPI assigned
Feb 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 00007582 AL
Addiction Medicine (Family Medicine) Physician 207QA0401X 7582 AL Primary

Addresses

Primary practice location

3485 Independence Dr
Homewood, AL 35209-5603

Mailing address

3485 Independence Dr
Homewood, AL 35209-5603
Phone (205) 930-0920

Other identifiers 11

IdentifierTypeStateIssuer
C76475OtherALVIVA
009940577MedicaidAL
0366100001OtherALMC NSC
2652937001OtherALCIGNA
4288415OtherALAETNA
000037357OtherALMEDICARE PTAN
000025362OtherALMEDICARE PTAN
1910076OtherALUNITED HEALTHCARE
0366100001OtherALCIGNA GOVERNMENT SERVICES PTAN
1910032OtherALUNITED HEALTHCARE
C76475OtherALHEALTH SPRINGS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050718000420 AL Practitioner - UrologyPractitioner - Addiction Medicine 4082640479 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00007582ALMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kolbe Clinic LLC Addiction Medicine CurrentSince Nov 23, 2019 Accepting new patients
Urology Centers of Alabama PC Urology Current Accepting new patients
Urology Centers of Alabama PC Current Accepting new patients

Locations

109 Foothills Pkwy
Ste A
Chelsea, AL 35043
Phone (205) 775-0300

109 Foothills Pkwy
Ste 113
Chelsea, AL 35043
Phone (205) 451-9742

3485 Independence Dr
Homewood, AL 35209

1830 Montclair Rd
Ste A
Irondale, AL 35210
Phone (205) 775-0300

Networks

  • bcbs alabama network 01G0
  • bcbs alabama network 01B0
  • bcbs alabama network 01I0
  • bcbs alabama network 01A0
  • bcbs alabama network 01H0
  • bcbs alabama network 01E0

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580688000000",
    "number": "1265405039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3485 INDEPENDENCE DR",
            "city": "HOMEWOOD",
            "state": "AL",
            "postal_code": "352095603",
            "telephone_number": "205-930-0920",
            "fax_number": "205-445-0115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3485 INDEPENDENCE DR",
            "city": "HOMEWOOD",
            "state": "AL",
            "postal_code": "352095603",
            "telephone_number": "205-930-0920",
            "fax_number": "205-445-0115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOODY",
        "first_name": "THOMAS",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-10",
        "last_updated": "2020-02-03",
        "certification_date": "2020-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "AL",
            "license": "00007582",
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "AL",
            "license": "7582",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIVA",
            "identifier": "C76475",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009940577",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MC NSC",
            "identifier": "0366100001",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2652937001",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4288415",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "000037357",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "000025362",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1910076",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA GOVERNMENT SERVICES PTAN",
            "identifier": "0366100001",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1910032",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH SPRINGS",
            "identifier": "C76475",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Homewood, AL

Sources for this page

Verify at the official NPI Registry.