Active NPI
Cynthia M Moody, LBSW, JP, IPR
- Case Manager/Care Coordinator
- Edinburg, TX
National Provider Identifier
1306084769
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- License
- 17286
- Practice address
- 2805 Fountain Plaza Blvd
Edinburg, TX 78539-8031 - Phone
- (956) 316-2224
- Fax
- (956) 316-1717
- NPI assigned
- Jan 22, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | |||
| Clinical Social Worker | 1041C0700X | |||
| Case Manager/Care Coordinator | 171M00000X | 17286 | TX | Primary |
Addresses
Primary practice location
2805 Fountain Plaza Blvd
Edinburg, TX 78539-8031
Mailing address
2805 Fountain Plaza Blvd
Edinburg, TX 78539-8031
Phone (956) 316-2224
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1988032 | Medicaid | TX |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17286 | TX | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rysty Enterprises, Inc | Past | Accepting new patients |
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.
-
- Family Nurse Practitioner
- Mission, TX
- NPI 1427438100
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1232582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315353600000",
"number": "1306084769",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2805 FOUNTAIN PLAZA BLVD",
"city": "EDINBURG",
"state": "TX",
"postal_code": "785398031",
"telephone_number": "956-316-2224",
"fax_number": "956-316-1717"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2805 FOUNTAIN PLAZA BLVD",
"city": "EDINBURG",
"state": "TX",
"postal_code": "785398031",
"telephone_number": "956-316-2224",
"fax_number": "956-316-1717"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOODY",
"first_name": "CYNTHIA",
"middle_name": "M",
"credential": "LBSW, JP, IPR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-01-22",
"last_updated": "2011-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "TX",
"license": "17286",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1988032",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Edinburg, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.