Allyson W Moulton, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

E8287 Issued in AR

Practice address

2 Medical Park Rd Ste 306
Columbia, SC 29203-6839

Phone

(803) 256-2657

NPI assigned

May 12, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1210550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460419200000",
    "number": "1366619132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "923 LEXINGTON AVE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729014943",
            "telephone_number": "479-709-7350",
            "fax_number": "479-709-7355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 MEDICAL PARK RD STE 306",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036839",
            "telephone_number": "803-256-2657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOULTON",
        "first_name": "ALLYSON",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-12",
        "last_updated": "2016-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "VA",
            "license": "0116020110",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SC",
            "license": "LL34981",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AR",
            "license": "E8287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Shuler Mothena, PA-C
• Natasha Myiah Moti, MA
• Ladelerie Anita Moton
• Thomas Joseph Motycka, M.D.
• Zachary Motzko
• Jasmine Monique Moultrie
• Kelly Moultrie
• Stacie Moultrie
• Monique Meshaun Moultry-Watson, LISW-CP
• Niccole Mount, NP

• Surgery Physician in Columbia, SC
• Providers in Columbia, SC by specialty
• Surgery Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.