Edward Bridges Moody, M.D.

Primary specialty

Preventive Medicine/Occupational Environmental Medicine PhysicianTaxonomy code 2083P0500X

Practice address

100 NE Randolph Ave
St. Francis Occupational Health
Peoria, IL 61606-1919

Phone

(309) 624-8525

NPI assigned

Mar 28, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Genesis Health System

  • Family Medicine Physician
  • Bettendorf, IA
  • NPI 1225018211
  NPD (past)

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275652653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 NE RANDOLPH AVE",
            "address_2": "ST. FRANCIS OCCUPATIONAL HEALTH",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616061919",
            "telephone_number": "309-624-8525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NE RANDOLPH AVE",
            "address_2": "ST. FRANCIS OCCUPATIONAL HEALTH",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616061919",
            "telephone_number": "309-624-8525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOODY",
        "first_name": "EDWARD",
        "middle_name": "BRIDGES",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Peter Monsberger, MD
• Kristina Sue Montelongo, LPC
• Daniel P Montemayor, M.D.
• Keri Montgomery
• Samantha A Mooberry, PA-C
• Gerald Rodger Moon, DDS
• Richard T Moon, DDS
• Jonathan William Mooney, PMHNP-BC
• Kari Mooneyham, SLP
• Aimee Moore, PTA

• Preventive Medicine/Occupational Environmental Medicine Physician in Peoria, IL
• Providers in Peoria, IL by specialty
• Preventive Medicine/Occupational Environmental Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.