Willis E Moody III, M.D.

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

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 6

Electronic endpoints 1

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

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

Union General Affiliated Services, LLCGroup PAC ID 4688927106, 20 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Union General Hospital Hospital, Blairsville, GA, CCN 110051
• Chatuge Regional Hospital Hospital, Hiawassee, GA, CCN 111324
• Northside Hospital Cherokee Hospital, Canton, GA, CCN 110008
• Northside Hospital Hospital, Atlanta, GA, CCN 110161

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

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

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.

• Union General Affiliated Services, LLC

  • Specialist
  • Blairsville, GA
  • NPI 1902305063

  GA, Surgery

  Medicare reassignment Care Compare group NPD
• Georgia Mountain Surgical Associates

  • Specialist
  • Blairsville, GA
  • NPI 1487774261
  NPD
• Union General Affiliated Services, LLC

  • Neurology Physician
  • Hiawassee, GA
  • NPI 1568841567
  NPD
• Chatuge Regional Hospital Inc

  • Internal Medicine Physician
  • Hiawassee, GA
  • NPI 1265811962
  NPD (past)
• Georgia Mountain Surgical Associates PC

  • Specialist
  • Blairsville, GA
  • NPI 1467508689
  NPD (past)
• Abingdon Physician Partners

  • Internal Medicine Physician
  • Abingdon, VA
  • NPI 1306944350
  NPD (past)

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

• Chatuge Regional Hospital Inc

  • Critical Access Hospital
  • Hiawassee, GA
  • NPI 1326028978

  Hospital

  Care Compare affiliation
• Northside Hospital, Inc.

  • General Acute Care Hospital
  • Canton, GA
  • NPI 1225050396

  Hospital

  Care Compare affiliation
• Northside Hospital, Inc.

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1457396079

  Hospital

  Care Compare affiliation
• Union County Hospital Authority

  • General Acute Care Hospital
  • Blairsville, GA
  • NPI 1487684122

  Hospital

  Care Compare affiliation

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": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "000570534D",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "839014891",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1487774261",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "386024",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "20-5788381",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP IDENTIFIER",
            "identifier": "GRP8005",
            "state": "GA"
        }
    ],
    "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": []
}

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• All providers in Blairsville, GA
• Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.