Active NPI
Victoria Joyce Moody, L.D., M.P.H.
- Dietary Manager
- Athens, GA
National Provider Identifier
1609077809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dietary Manager
- License
- LD000807
- Practice address
- 189 Paradise Blvd
Athens, GA 30607-1121 - Phone
- (706) 338-9185
- NPI assigned
- May 29, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Dietary Manager | 132700000X | LD000807 | GA | Primary |
| Nutrition Education Nutritionist | 133NN1002X | LD000807 | GA |
Addresses
Primary practice location
189 Paradise Blvd
Athens, GA 30607-1121
Mailing address
1340 Palomino Pass
Bogart, GA 30622-2889
Phone (706) 583-2859
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LD000807 | GA | MD | Dietary Manager |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180396800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1367884800000",
"number": "1609077809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1340 PALOMINO PASS",
"city": "BOGART",
"state": "GA",
"postal_code": "306222889",
"telephone_number": "706-583-2859",
"fax_number": "706-543-2034"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "189 PARADISE BLVD",
"city": "ATHENS",
"state": "GA",
"postal_code": "306071121",
"telephone_number": "706-338-9185"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOODY",
"first_name": "VICTORIA",
"middle_name": "JOYCE",
"credential": "L.D., M.P.H.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-29",
"last_updated": "2013-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "132700000X",
"taxonomy_group": "",
"desc": "Dietary Manager",
"state": "GA",
"license": "LD000807",
"primary": true
},
{
"code": "133NN1002X",
"taxonomy_group": "",
"desc": "Nutritionist, Nutrition, Education",
"state": "GA",
"license": "LD000807",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Athens, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.