Individual provider Active NPI

John Simpson Moss, MD

  • Orthopaedic Surgery Physician
  • Roanoke Rapids, NC
National Provider Identifier
1457424764
Registry record updated Aug 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
200700158 Issued in NC
Practice address
171 NC Highway 125
Roanoke Rapids, NC 27870-6460
Phone
(252) 537-5639
Fax
(252) 537-7198
NPI assigned
Nov 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 200700158 NC Primary

Addresses

Primary practice location

171 NC Highway 125
Roanoke Rapids, NC 27870-6460

Mailing address

120 William Penn PLZ
Durham, NC 27704-2150
Phone (919) 220-5255

Other identifiers 2

IdentifierTypeStateIssuer
5910110MedicaidNC
010091209MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20080311000719 NC Practitioner - Orthopedic Surgery 1759352313 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
200700158NCMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergeortho PA Orthopaedic Surgery CurrentSince Sep 8, 2014 Accepting new patients
Vidant Medical Group LLC CurrentSince Nov 9, 2021 Accepting new patients
Vidant Medical Group LLC CurrentSince Nov 9, 2021 Accepting new patients
Emergeortho PA CurrentSince Sep 8, 2014 Accepting new patients
Northern Carolina Orthopaedics, PLLC Orthopaedic Surgery PastSince Apr 1, 2009 Accepting new patients
John S Moss MD P L L C Orthopaedic Surgery PastSince May 30, 2006 Accepting new patients

Locations

120 William Penn Plz
Durham, NC 27704
Phone (919) 281-1836

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

171 NC Highway 125
Roanoke Rapids, NC 27870
Phone (252) 537-5631

799 Doctors Ct
Roxboro, NC 27573
Phone (336) 599-4079

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440979200000",
    "number": "1457424764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 WILLIAM PENN PLZ",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277042150",
            "telephone_number": "919-220-5255",
            "fax_number": "919-313-1276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 NC HIGHWAY 125",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278706460",
            "telephone_number": "252-537-5639",
            "fax_number": "252-537-7198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSS",
        "first_name": "JOHN",
        "middle_name": "SIMPSON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-16",
        "last_updated": "2015-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NC",
            "license": "200700158",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5910110",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010091209",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke Rapids, NC

Sources for this page

Verify at the official NPI Registry.