Individual provider Active NPI

Ann T Moell, MD

  • Family Medicine Physician
  • Dayton, OH
National Provider Identifier
1457378978
Registry record updated Mar 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35-060654 M Issued in OH
Practice address
359 Forest Ave
Dayton, OH 45405-4563
Phone
(937) 228-4492
NPI assigned
Jul 17, 2006
Last updated
Mar 25, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35-060654 M OH Primary

Addresses

Primary practice location

359 Forest Ave
Dayton, OH 45405-4563

Mailing address

359 Forest Ave
Dayton, OH 45405-4563
Phone (937) 228-4492

Other identifiers 1

IdentifierTypeStateIssuer
0966969MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20040708000237 OH Practitioner - Family Practice 4981682960 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35-060654 MOHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Holy Family Prenatal Care, LLC CurrentSince Jan 1, 2004 Accepting new patients
Alliance Physicians Inc Family Medicine CurrentSince Jul 1, 2014 Accepting new patients
Signify Health, LLC CurrentSince Oct 31, 2023 Accepting new patients
Alliance Physicians Inc CurrentSince Jul 1, 2014 Accepting new patients
Dayton Osteopathic Hospital Past Accepting new patients
Medical Service Associates of Xenia Inc Family Medicine Past Accepting new patients

Locations

175 S 3rd St
Ste 200
Columbus, OH 43215
Phone (267) 817-8902

359 Forest Ave
Ste 202
Dayton, OH 45405
Phone (937) 228-4492

2115 Leiter Rd
Miamisburg, OH 45342
Phone (937) 384-6920

1141 N Monroe Dr
Xenia, OH 45385
Phone (937) 352-2000

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 7

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395705600000",
    "number": "1457378978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "359 FOREST AVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454054563",
            "telephone_number": "937-228-4492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "359 FOREST AVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454054563",
            "telephone_number": "937-228-4492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOELL",
        "first_name": "ANN",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2014-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35-060654 M",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0966969",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.