Active NPI
David Moss, O.D.
- Optometrist
- Memphis, TN
National Provider Identifier
1376587436
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1350
- Practice address
- 2705 Appling Rd
Ste. 102
Memphis, TN 38133-5082 - Phone
- (901) 266-7189
- Fax
- (901) 382-8994
- NPI assigned
- Jun 16, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1350 | TN | Primary |
Addresses
Primary practice location
2705 Appling Rd
Ste. 102
Memphis, TN 38133-5082
Mailing address
2705 Appling Rd
Ste. 102
Memphis, TN 38133-5082
Phone (901) 266-7189
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| TN1350 | Other | TN | TN LICENSE |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1350 | TN | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1376587436",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2705 APPLING RD",
"address_2": "STE. 102",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381335082",
"telephone_number": "901-266-7189",
"fax_number": "901-382-8994"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2705 APPLING RD",
"address_2": "STE. 102",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381335082",
"telephone_number": "901-266-7189",
"fax_number": "901-382-8994"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOSS",
"first_name": "DAVID",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TN",
"license": "1350",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TN LICENSE",
"identifier": "TN1350",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.