Mechelle L Moody, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

046890 Issued in GA

Practice address

4970 Highway 90
Marianna, FL 32446-6802

Phone

(850) 718-5620

Fax

(850) 718-5670

NPI assigned

Jun 12, 2007

Last updated

Jan 11, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mechelle L Moody Professional name

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Hospital Authority of the City of Bainbridge and Decatur County

  dba Memorial Hospital and Manor

  • Multi-Specialty Clinic/Center
  • Bainbridge, GA
  • NPI 1053388256
  NPD (past)

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

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263168000000",
    "number": "1477757839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4970 HIGHWAY 90",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324466802",
            "telephone_number": "850-718-5620",
            "fax_number": "850-718-5670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4970 HIGHWAY 90",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324466802",
            "telephone_number": "850-718-5620",
            "fax_number": "850-718-5670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOODY",
        "first_name": "MECHELLE",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-12",
        "last_updated": "2010-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "046890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GA STATE LICENSE",
            "identifier": "046890",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MECHELLE",
            "last_name": "MOODY",
            "middle_name": "L",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Anastasia Demetria Mitchell
• Keionna D Mitchell, APRN
• Mja Compassionate Caregivers LLC
• Deborah Mobley, LMHC
• Josel Dalangin Montero
• Holli Lynn Mooney, APRN
• Carlos Esteban Moreyra, MD
• Meghan Morris
• MRNC, LLC (Courtyard Rehabilitation and Nursing Center)
• Cassandra Mullins

• Internal Medicine Physician in Marianna, FL
• Providers in Marianna, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.