Active NPI
Christopher J Moss, DHSC, ATC
- Athletic Trainer
- Kentland, IN
National Provider Identifier
1467480509
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 36000089A
- Practice address
- 13102 S 50 E
Kentland, IN 47951-8540 - Phone
- (219) 474-5167
- Fax
- (219) 474-6592
- NPI assigned
- Jun 29, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT0000000852 | TN | |
| Athletic Trainer | 2255A2300X | 36000089A | IN | Primary |
Addresses
Primary practice location
13102 S 50 E
Kentland, IN 47951-8540
Mailing address
1104 E Grace St
Rensselaer, IN 47978-3211
Phone (219) 866-5141
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36000089A | IN | MD | Athletic Trainer |
| AT0000000852 | TN | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1328745600000",
"number": "1467480509",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1104 E GRACE ST",
"city": "RENSSELAER",
"state": "IN",
"postal_code": "479783211",
"telephone_number": "219-866-5141",
"fax_number": "219-866-3619"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13102 S 50 E",
"city": "KENTLAND",
"state": "IN",
"postal_code": "479518540",
"telephone_number": "219-474-5167",
"fax_number": "219-474-6592"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOSS",
"first_name": "CHRISTOPHER",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "DHSC, ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-29",
"last_updated": "2012-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "TN",
"license": "AT0000000852",
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IN",
"license": "36000089A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kentland, IN
- Iroquois Memorial Hospital and Resident Home (IMH Kentland Clinic)
- Kentland Family Dentistry
- Lowell G. Mitchell Jr.
- Michelle Stoyanov Moore, PA-C
- Deborah L Morgan, N.P.
- Jayne Frances Polen, SLPA
- Proactive Mso, LLC (Proactive MD South Newton Health Center)
- South Newton School Corporation
- Jessica St. John
- Brandon Wu, PHARMD, R.PH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.