Active NPI
Pickens Moyd Jr.
- Family Medicine Physician
- Society Hill, SC
National Provider Identifier
1518072859
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 12990
- Practice address
- 737 S Main St
Society Hill, SC 29593-8972 - Phone
- (843) 378-4501
- NPI assigned
- Aug 19, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 12990 | SC | Primary |
Addresses
Primary practice location
737 S Main St
Society Hill, SC 29593-8972
Mailing address
737 S Main St
Society Hill, SC 29593-8972
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 129907 | Medicaid | SC | |
| P00124099 | Other | SC | RAILROAD MEDICARE PTAN |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12990 | SC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1504224000000",
"number": "1518072859",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "737 S MAIN ST",
"city": "SOCIETY HILL",
"state": "SC",
"postal_code": "295938972"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "737 S MAIN ST",
"city": "SOCIETY HILL",
"state": "SC",
"postal_code": "295938972",
"telephone_number": "843-378-4501"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOYD",
"first_name": "PICKENS",
"name_suffix": "Jr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-19",
"last_updated": "2017-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "SC",
"license": "12990",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "129907",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE PTAN",
"identifier": "P00124099",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Society Hill, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.