Active NPI
Colin Lee Moffett, D.P.M.
- Primary Podiatric Medicine Podiatrist
- Gastonia, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Podiatric Medicine Podiatrist
- License
- 139
- Practice address
- 111 E 3Rd Ave
Gastonia, NC 28052-4317 - Phone
- (704) 874-3300
- NPI assigned
- May 10, 2006
- Last updated
- May 3, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Podiatric Medicine Podiatrist | 213EP1101X | 139 | NC | Primary |
| Foot Surgery Podiatrist | 213ES0131X | 139 | NC |
Addresses
Primary practice location
111 E 3Rd Ave
Gastonia, NC 28052-4317
Mailing address
200 E 2ND Ave
Gastonia, NC 28052-4358
Phone (704) 874-1900
Other practice location 1
143 N 3rd St
Albemarle, NC 28001-4901
Phone (704) 983-5763
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8908125 | Medicaid | NC | |
| 56-1384996 | Other | NC | TAX ID |
| 08125 | Other | NC | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Podiatry
- Education
- California School of Podiatric Medicine, 1980
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
420 N Salisbury St
Lexington, NC 27292-3548
Phone (336) 249-6215
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 139 | NC | MD | Primary Podiatric Medicine Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Uwharrie Podiatry, LLC | Current | Accepting new patients | |
| Gaston Family Health Services, Inc. | Current | Accepting new patients | |
| Gaston Family Health Services, Inc | Current | Accepting new patients | |
| Dpmmoffettnrnc LLC | Podiatrist | Past | Accepting new patients |
Locations
143 N 3rd St
Albemarle, NC 28001
Phone (704) 786-4482
111 E 3rd Ave
Gastonia, NC 28052
Phone (704) 853-5079
200 E 2nd Ave
Gastonia, NC 28052
Phone (704) 874-1904
991 W Hudson Blvd
Gastonia, NC 28052
Phone (704) 853-5000
Interoperability endpoints
- cmoffett655843@direct.ochin.org
Organizations & group practices 4
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.
-
dba Kintegra Family Medicine - Hudson
- Federally Qualified Health Center (FQHC)
- Gastonia, NC
- NPI 1215932215
-
- Podiatric Clinic/Center
- Albemarle, NC
- NPI 1194990994
-
- Podiatrist
- Wilkesboro, NC
- NPI 1144275124
-
dba Kintegra Family Medicine - Xray Dr
- Federally Qualified Health Center (FQHC)
- Gastonia, NC
- NPI 1306644315
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714694400000",
"number": "1568411007",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 E 2ND AVE",
"city": "GASTONIA",
"state": "NC",
"postal_code": "280524358",
"telephone_number": "704-874-1900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 E 3RD AVE",
"city": "GASTONIA",
"state": "NC",
"postal_code": "280524317",
"telephone_number": "704-874-3300"
}
],
"practiceLocations": [
{
"address_1": "143 N 3rd St",
"address_purpose": "LOCATION",
"city": "Albemarle",
"state": "NC",
"postal_code": "280014901",
"country_code": "US",
"telephone_number": "704-983-5763",
"fax_number": "704-983-5642",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MOFFETT",
"first_name": "COLIN",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "D.P.M.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-10",
"last_updated": "2024-05-03",
"certification_date": "2024-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "213EP1101X",
"taxonomy_group": "",
"desc": "Podiatrist, Primary Podiatric Medicine",
"state": "NC",
"license": "139",
"primary": true
},
{
"code": "213ES0131X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot Surgery",
"state": "NC",
"license": "139",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8908125",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "56-1384996",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "08125",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Gastonia, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2024; 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.