Individual provider Active NPI

Victoria Joyce Moody, L.D., M.P.H.

  • Dietary Manager
  • Athens, GA
National Provider Identifier
1609077809
Registry record updated May 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dietary ManagerTaxonomy code 132700000X
License
LD000807 Issued in GA
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

Updated by the provider on May 7, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
LD000807GAMDDietary 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.

Verify at the official NPI Registry.