Active NPI
Bryan Corley Moffitt, L.P.C.
- Professional Counselor
- Lubbock, TX
National Provider Identifier
1548356181
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 12735
- Practice address
- 5701 Avenue P
Lubbock, TX 79412-3674 - Phone
- (806) 747-3488
- Fax
- (806) 747-3219
- NPI assigned
- Oct 4, 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 12735 | TX | Primary |
Addresses
Primary practice location
5701 Avenue P
Lubbock, TX 79412-3674
Mailing address
5701 Avenue P
Lubbock, TX 79412-3674
Phone (806) 747-3488
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 022779 | Other | TX | VMC EAP |
| 152320101 | Medicaid | TX | |
| 22100 | Other | TX | FIRSTCARE COMMERCIAL |
| 83479L | Other | TX | BCBS TEXAS |
| 207800 | Other | TX | COMPSYCH EAP |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12735 | TX | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349654400000",
"number": "1548356181",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5701 AVENUE P",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794123674",
"telephone_number": "806-747-3488",
"fax_number": "806-747-3219"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5701 AVENUE P",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794123674",
"telephone_number": "806-747-3488",
"fax_number": "806-747-3219"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOFFITT",
"first_name": "BRYAN",
"middle_name": "CORLEY",
"credential": "L.P.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-04",
"last_updated": "2012-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "12735",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VMC EAP",
"identifier": "022779",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "152320101",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRSTCARE COMMERCIAL",
"identifier": "22100",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS TEXAS",
"identifier": "83479L",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMPSYCH EAP",
"identifier": "207800",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lubbock, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2012; 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.