Individual provider Active NPI

Madison McKinney Moss, OD

  • Optometrist
  • Cary, NC
National Provider Identifier
1275159873
Registry record updated Mar 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2647 Issued in NC
Practice address
1400 Crescent GRN Ste 305
Cary, NC 27518-8118
Phone
(919) 850-5910
Fax
(919) 701-4641
NPI assigned
Jun 19, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2020015993 MO
Corneal and Contact Management Optometrist 152WC0802X 2647 NC
Corneal and Contact Management Optometrist 152WC0802X 2020015993 MO
Optometrist 152W00000X 2647 NC Primary

Addresses

Primary practice location

1400 Crescent GRN Ste 305
Cary, NC 27518-8118

Mailing address

1400 Crescent GRN Ste 305
Cary, NC 27518-8118
Phone (919) 850-5910

Other names 1

  • Madison Elizabeth McKinney Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211011000410 NC Practitioner - Optometry 3577985340 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2647NCMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Carrboro Family Vision LLC Optometrist CurrentSince Jul 1, 2021 Accepting new patients

Locations

200 W Weaver St
Ste 1
Carrboro, NC 27510
Phone (919) 968-6300

Organizations & group practices 1

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": "1592524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741651200000",
    "number": "1275159873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 CRESCENT GRN STE 305",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275188118",
            "telephone_number": "919-850-5910",
            "fax_number": "919-701-4641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 CRESCENT GRN STE 305",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275188118",
            "telephone_number": "919-850-5910",
            "fax_number": "919-701-4641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSS",
        "first_name": "MADISON",
        "middle_name": "MCKINNEY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-19",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2020015993",
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "NC",
            "license": "2647",
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "MO",
            "license": "2020015993",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "2647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MADISON",
            "last_name": "MCKINNEY",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cary, NC

Sources for this page

Verify at the official NPI Registry.