NPIMap

Individual provider Active NPI

David Lawrence Moody, MD

  • Family Medicine Physician
  • Carthage, MS
National Provider Identifier
1346359197
Registry record updated Dec 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
08774 Issued in MS
Practice address
1071 E Franklin St
Carthage, MS 39051-3601
Phone
(601) 267-4562
Fax
(601) 267-4589
NPI assigned
Aug 29, 2006
Last updated
Dec 3, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 08774 MS Primary

Addresses

Primary practice location

1071 E Franklin St
Carthage, MS 39051-3601

Mailing address

PO Box 435
Carthage, MS 39051-0435
Phone (601) 267-3625

Other identifiers 1

IdentifierTypeStateIssuer
00017434MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040928000103 MS Practitioner - Family Practice 7113838715 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Mississippi School of Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Madden Medical Clinic, LLCGroup PAC ID 4880663863, 2 clinicians

Practice addresses (Care Compare)

1071 E Franklin St
Carthage, MS 39051-3601
Phone (601) 267-4562

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Madden Medical Clinic LLC CurrentSince Oct 1, 2004 Accepting new patients
Mississippi Band of Choctaw Indians Past Accepting new patients
Baptist Medical Center-Leake, Inc. Past Accepting new patients
Trend Health and Rehab of Carthage Past Accepting new patients
Carthage Senior Care Past Accepting new patients

Locations

1071 E Franklin St
Carthage, MS 39051
Phone (601) 267-4562

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543795200000",
    "number": "1346359197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 435",
            "city": "CARTHAGE",
            "state": "MS",
            "postal_code": "390510435",
            "telephone_number": "601-267-3625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1071 E FRANKLIN ST",
            "city": "CARTHAGE",
            "state": "MS",
            "postal_code": "390513601",
            "telephone_number": "601-267-4562",
            "fax_number": "601-267-4589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOODY",
        "first_name": "DAVID",
        "middle_name": "LAWRENCE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2018-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "08774",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00017434",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carthage, MS

Sources for this page

Verify at the official NPI Registry.