NPIMap

Organization Active NPI

Thomas Ae Moseley

  • Pediatrics Physician
  • Newport, VT
National Provider Identifier
1366515249
Registry record updated Mar 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
420006774 Issued in VT
Legal business name
THOMAS AE MOSELEY
Practice address
121 Medical Village Drive
Newport, VT 05855
Phone
(802) 334-6929
Fax
(802) 784-1051
NPI assigned
Nov 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2012

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

Authorized official

Name
Mr. Thomas Ae Moseley III, MD
Title
Owner
Phone
(802) 334-5929

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X 1010022369 VT
Pediatrics PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208000000X 420006774 VT Primary
Pediatrics PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208000000X 0420010849 VT

Addresses

Primary practice location

121 Medical Village Drive
Newport, VT 05855

Mailing address

121 Medical Village Drive
Newport, VT 05855
Phone (802) 334-6929

Other identifiers 1

IdentifierTypeStateIssuer
0473814MedicaidVT

Other names 1

  • Newport Pediatrics & Adolescent Medicine PLLC Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331683200000",
    "number": "1366515249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 MEDICAL VILLAGE DRIVE",
            "city": "NEWPORT",
            "state": "VT",
            "postal_code": "05855",
            "telephone_number": "802-334-6929",
            "fax_number": "802-784-1051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 MEDICAL VILLAGE DRIVE",
            "city": "NEWPORT",
            "state": "VT",
            "postal_code": "05855",
            "telephone_number": "802-334-6929",
            "fax_number": "802-784-1051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS AE MOSELEY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-16",
        "last_updated": "2012-03-14",
        "status": "A",
        "authorized_official_last_name": "MOSELEY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "AE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "802-334-5929",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "VT",
            "license": "1010022369",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "VT",
            "license": "420006774",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "VT",
            "license": "0420010849",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0473814",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Newport Pediatrics & Adolescent Medicine PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newport, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2012; 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.