Individual provider Active NPI

David F Moulton, MD

  • Internal Medicine Physician
  • Johnson City, TN
National Provider Identifier
1407851603
Registry record updated May 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20674 Issued in TN
Practice address
802 Lizabeth Dr
Johnson City, TN 37604-1949
Phone
(423) 283-0733
NPI assigned
Jun 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 20674 TN Primary

Addresses

Primary practice location

802 Lizabeth Dr
Johnson City, TN 37604-1949

Mailing address

802 Lizabeth Dr
Johnson City, TN 37604-1949

Other identifiers 1

IdentifierTypeStateIssuer
3052491MedicaidTN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100210000128 TN Practitioner - Internal Medicine 5496758161 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
State of Franklin Healthcare Associates PLLC Internal Medicine CurrentSince Jul 1, 1998 Accepting new patients
State of Franklin Healthcare Associates PLLC PastSince Aug 18, 2019 Accepting new patients

Locations

5 Worth Cir
Ste 4
Johnson City, TN 37601
Phone (423) 282-4819

313 Princeton Rd
Ste 3
Johnson City, TN 37601
Phone (423) 282-4819

219 Princeton Rd
Ste 200
Johnson City, TN 37601
Phone (423) 282-4911

215 E Springbrook Dr
Johnson City, TN 37601
Phone (423) 530-7900

301 Med Tech Pkwy
Ste 240
Johnson City, TN 37604
Phone (423) 794-5520

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24871/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1118793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748304000000",
    "number": "1407851603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 LIZABETH DR",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376041949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 LIZABETH DR",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376041949",
            "telephone_number": "423-283-0733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOULTON",
        "first_name": "DAVID",
        "middle_name": "F",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-15",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "20674",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3052491",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.