Renee Marie Moss, CMT

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

1420 E 17TH St
Suite E
Idaho Falls, ID 83404-6283

Phone

(208) 243-2668

NPI assigned

Dec 1, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1259625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259625600000",
    "number": "1376871335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 E 17TH ST",
            "address_2": "SUITE E",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046283",
            "telephone_number": "208-243-2668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 E 17TH ST",
            "address_2": "SUITE E",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046283",
            "telephone_number": "208-243-2668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSS",
        "first_name": "RENEE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "CMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-12-01",
        "last_updated": "2009-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Morton
• Myra Emily Moses, LCSW
• Moss Chiropractic, P.a.
• Candis Caye Moss, LCSW
• Daryl A Moss, D.C.
• Sheila Moss, FNP-C
• Moulton Periodontics, PLLC
• Barbara J Moulton
• Ethan D. Moulton, D.D.S.,M.S.
• Mountain Care Pharmacy Idaho

• Community Health Worker in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Community Health Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2009; 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.