Micah Moulder

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

110 South Main Street
Campus Box 7246
Boiling Springs, NC 28017

Phone

(864) 985-3821

NPI assigned

May 4, 2026

Last updated

May 4, 2026By the provider in NPPES

Sex

Male

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": "1777852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777852800000",
    "number": "1457298770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 SOUTH MAIN STREET",
            "address_2": "CAMPUS BOX 7246",
            "city": "BOILING SPRINGS",
            "state": "NC",
            "postal_code": "28017",
            "telephone_number": "864-985-3821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 SOUTH MAIN STREET",
            "address_2": "CAMPUS BOX 7246",
            "city": "BOILING SPRINGS",
            "state": "NC",
            "postal_code": "28017",
            "telephone_number": "864-985-3821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOULDER",
        "first_name": "MICAH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-05-04",
        "last_updated": "2026-05-04",
        "certification_date": "2026-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Stephany Martinez, PA-C
• Jaimesha Alise McKenzie
• Joseph William Medel, ATC
• Ashley Miles, LAT, ATC
• Jon Thomas Mitchell, ATC
• Eric Joseph Newton, LAT, ATC
• Leira Phillips
• Professional Pharmacy Inc (Professional Pharmacy)
• Rutherford Hospital Inc (Boiling Springs Family Care)
• Brooke Weatherford Smithers, RN, MSN

• Student in an Organized Health Care Education/Training Program in Boiling Springs, NC
• Providers in Boiling Springs, NC by specialty
• Student in an Organized Health Care Education/Training Program in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2026; 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.