Active NPI
Kevin Moss, MD
- Pulmonary Disease Physician
- New Smyrna Beach, FL
National Provider Identifier
1265987937
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- 4301063798
- Practice address
- 1055 N Dixie Fwy Ste 1
New Smyrna Beach, FL 32168-6200 - Phone
- (386) 423-0505
- Fax
- (386) 423-0515
- NPI assigned
- Aug 23, 2016
- Last updated
- Aug 23, 2016
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pulmonary Disease Physician | 207RP1001X | 4301063798 | MI | Primary |
Addresses
Primary practice location
1055 N Dixie Fwy Ste 1
New Smyrna Beach, FL 32168-6200
Mailing address
1055 N Dixie Fwy Ste 1
New Smyrna Beach, FL 32168-6200
Phone (386) 423-0505
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4301063798 | Other | MI | MEDICAL LICENSE NUMBER |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301063798 | MI | MD | Pulmonary Disease Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1471910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1471910400000",
"number": "1265987937",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1055 N DIXIE FWY STE 1",
"city": "NEW SMYRNA BEACH",
"state": "FL",
"postal_code": "321686200",
"telephone_number": "386-423-0505",
"fax_number": "386-423-0515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1055 N DIXIE FWY STE 1",
"city": "NEW SMYRNA BEACH",
"state": "FL",
"postal_code": "321686200",
"telephone_number": "386-423-0505",
"fax_number": "386-423-0515"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOSS",
"first_name": "KEVIN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-08-23",
"last_updated": "2016-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "MI",
"license": "4301063798",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE NUMBER",
"identifier": "4301063798",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in New Smyrna Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.