Individual provider Active NPI

Donna Martin Moss, LCSW, GC-C

  • Clinical Social Worker
  • Gainesville, GA
National Provider Identifier
1285715896
Registry record updated Jan 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW001860 Issued in GA
Practice address
1211 Sherwood Park Dr NE Ste B
Gainesville, GA 30501-3444
Phone
(770) 219-9179
NPI assigned
Oct 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CSW001860 GA Primary

Addresses

Primary practice location

1211 Sherwood Park Dr NE Ste B
Gainesville, GA 30501-3444

Mailing address

PO Box 742616
Atlanta, GA 30374-2616
Phone (770) 219-8420

Other practice location 1

621 Washington St SW
Suite A
Gainesville, GA 30501-8567
Phone (770) 287-1356

Other practice location 2

1285 Sims St
Gainesville, GA 30501-3851
Phone (770) 219-9179

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dmoss6099@nghs.gadirect.net Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111116000554 GA Practitioner - Clinical Social Worker 4486828068 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1285 Sims St
Gainesville, GA 30501-3851
Phone (770) 536-0149

Merit-based Incentive Payment System (MIPS)

Final score
87.83 of 100Reported as group
Quality
80.36
Promoting interoperability
100
Improvement activities
40
Cost
79.08

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Georgia Medical Center, Inc. Current Accepting new patients
Northeast Georgia Medical Center, Inc. CurrentSince Oct 4, 2011 Accepting new patients
Northeast Georgia Physicians Group Inc CurrentSince Jan 24, 2018 Accepting new patients

Locations

743 Spring St NE
Gainesville, GA 30501
Phone (770) 219-5915

1285 Sims St
Gainesville, GA 30501
Phone (770) 219-8583

1211 Sherwood Park Dr NE
Ste B
Gainesville, GA 30501
Phone (770) 219-3202

597 S Enota Dr NE
Gainesville, GA 30501
Phone (770) 219-8275

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": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610668800000",
    "number": "1285715896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742616",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742616",
            "telephone_number": "770-219-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 SHERWOOD PARK DR NE STE B",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013444",
            "telephone_number": "770-219-9179"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "621 Washington St SW",
            "address_2": "Suite A",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "GA",
            "postal_code": "305018567",
            "country_code": "US",
            "telephone_number": "770-287-1356",
            "fax_number": "770-287-3152",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1285 Sims St",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "GA",
            "postal_code": "305013851",
            "country_code": "US",
            "telephone_number": "770-219-9179",
            "fax_number": "770-219-9612",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOSS",
        "first_name": "DONNA",
        "middle_name": "MARTIN",
        "credential": "LCSW, GC-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2021-01-15",
        "certification_date": "2021-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW001860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dmoss6099@nghs.gadirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1211 Sherwood Park Dr NE Ste B",
            "city": "Gainesville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "305013444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

Verify at the official NPI Registry.