Corey Jordan Moser, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

Practice address

142 Bermuda Village Dr
Bermuda Run, NC 27006-7867

Phone

(336) 998-6112

NPI assigned

Dec 30, 2018

Last updated

Dec 30, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1546128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546128000000",
    "number": "1528530623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1596 WESTLAND LN",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270129715",
            "telephone_number": "336-501-0415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 BERMUDA VILLAGE DR",
            "city": "BERMUDA RUN",
            "state": "NC",
            "postal_code": "270067867",
            "telephone_number": "336-998-6112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSER",
        "first_name": "COREY",
        "middle_name": "JORDAN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-30",
        "last_updated": "2018-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NC",
            "license": "A5319",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tammy Nicole Knox, PT
• Rebecca Korona
• Corinne Makdisi, OTR/L
• Allyson Elizabeth Mentock, MD
• ML Bermuda Village, LLC (Bermuda Village Retirement Center)
• Katelyn Helen Moser, PA-C
• Navid Azar Nafissi, MD
• Luke Christopher Naylor, PA-C
• North Carolina Baptist Hospital (Bermuda Run Pharmacy)
• Novant Health Medical Group, LLC (Novant Health Neurology and Sleep)

• Physical Therapy Assistant in Bermuda Run, NC
• Providers in Bermuda Run, NC by specialty
• Physical Therapy Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.