Eric David Moffet, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD020620 Issued in TN

Practice address

1920 Brookside Dr
Suite 15
Kingsport, TN 37660

Phone

(423) 392-6500

Fax

(423) 392-6504

NPI assigned

Aug 26, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Virginia Commonwealth University, School of Medicine, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Psychiatric Care of Kingsport PC

  • Psychiatry Physician
  • Kingsport, TN
  • NPI 1326732793
  Medicare reassignment NPD
• Psychiatric Associates of Kingsport LLP

  • Psychiatry Physician
  • Kingsport, TN
  • NPI 1750485322
  NPD Authorized official

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

{
    "created_epoch": "1156550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215561600000",
    "number": "1609984178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 BROOKSIDE DR",
            "address_2": "SUITE 15",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "37660",
            "telephone_number": "423-392-6500",
            "fax_number": "423-392-6504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 BROOKSIDE DR",
            "address_2": "SUITE 15",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "37660",
            "telephone_number": "423-392-6500",
            "fax_number": "423-392-6504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOFFET",
        "first_name": "ERIC",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-26",
        "last_updated": "2008-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TN",
            "license": "MD020620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3052859",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TN",
            "identifier": "0105831",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS VA",
            "identifier": "069099",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy E. Mize, LPE
• Howard Mize Jr., M.D.
• MMDS Idtf LLC
• MMDS of Kingsport, LLC
• MMDS, LLC (Stat Xrays)
• Jennifer Leigh Mongold, MA
• Amy R Monroe, DPT
• Callie Darlene Montgomery, F.N.P.
• Randall Cline Montgomery, DDS
• Leah Nicole Moon, MD

• Psychiatry Physician in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Psychiatry Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2008; 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.

Verify at the official NPI Registry.