Individual provider Active NPI

Willis E Moody III, M.D.

  • Surgery Physician
  • Blairsville, GA
National Provider Identifier
1497736664
Registry record updated May 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
058708 Issued in GA
Practice address
191 Deep South Farm Rd
Blairsville, GA 30512-2220
Phone
(706) 781-6950
NPI assigned
Nov 7, 2005
Last updated
May 19, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 058708 GA Primary

Addresses

Primary practice location

191 Deep South Farm Rd
Blairsville, GA 30512-2220

Mailing address

35 Hospital Rd
Blairsville, GA 30512-3139
Phone (706) 745-2111

Other practice location 1

37 Hospital Way
Building 9, Suite B
Blairsville, GA 30512-3144
Phone (706) 781-6950

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address willismoody@uniongeneral.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20070425000108 GA Practitioner - General Surgery 9133224868 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Medical College of Georgia School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

35 Hospital Rd
Blairsville, GA 30512-3139
Phone 70674521116137

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy106
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)24
Upper gastrointestinal (GI) endoscopy for acid reflux123
Melanoma (skin cancer) excision21
Removal of tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
058708GAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Mountain Surgical Associates CurrentSince Feb 1, 2007 Accepting new patients
Union General Affiliated Services, LLC CurrentSince Apr 1, 2023 Accepting new patients
Union General Affiliated Services, LLC Surgery CurrentSince Apr 1, 2023 Accepting new patients
Chatuge Regional Hospital Inc Past Accepting new patients
Abingdon Physician Partners Past Accepting new patients
Georgia Mountain Surgical Associates PC Past Accepting new patients

Locations

123 Weaver Rd
#A
Blairsville, GA 30512
Phone (706) 745-9417

191 Deep South Farm Rd
Blairsville, GA 30512
Phone (706) 439-6380

35 Hospital Rd
Blairsville, GA 30512
Phone (706) 439-6812

37 Hospital Way
#B
Blairsville, GA 30512
Phone (706) 781-6950

110 S Main St
Hiawassee, GA 30546
Phone (706) 896-2222

Interoperability endpoints

  • Direct secure messaging: moody.willis.001.0100040@sang.meditab.direct-ci.com
  • Direct secure messaging: willismoody@uniongeneral.cernerdirect.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684454400000",
    "number": "1497736664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 HOSPITAL RD",
            "city": "BLAIRSVILLE",
            "state": "GA",
            "postal_code": "305123139",
            "telephone_number": "706-745-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 DEEP SOUTH FARM RD",
            "city": "BLAIRSVILLE",
            "state": "GA",
            "postal_code": "305122220",
            "telephone_number": "706-781-6950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "37 Hospital Way",
            "address_2": "Building 9, Suite B",
            "address_purpose": "LOCATION",
            "city": "Blairsville",
            "state": "GA",
            "postal_code": "305123144",
            "country_code": "US",
            "telephone_number": "706-781-6950",
            "fax_number": "706-781-6955",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOODY",
        "first_name": "WILLIS",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-07",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "058708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "willismoody@uniongeneral.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Email",
            "address_1": "35 Hospital Rd",
            "city": "Blairsville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "305123139",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Blairsville, GA

Sources for this page

Verify at the official NPI Registry.