Individual provider Active NPI

Alexandra Moody

  • Student in an Organized Health Care Education/Training Program
  • Englewood, CO
National Provider Identifier
1629568977
Registry record updated Jul 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
TL0009554 Issued in CO
Practice address
501 E Hampden Ave
Englewood, CO 80113-2702
Phone
(801) 680-9182
NPI assigned
May 12, 2018
Last updated
Jul 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X TL0009554 CO Primary

Addresses

Primary practice location

501 E Hampden Ave
Englewood, CO 80113-2702

Mailing address

5050 E Granite Cliffs Rd
Sandy, UT 84092-6221
Phone (801) 680-2964

Other names 1

  • Lexi Moody Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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

Enrollment IDStateProvider typePAC IDDetails
I20230719002041 CO Order and Referring Only - General SurgeryPractitioner - General Surgery 2567822711

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TL0009554COMDStudent in an Organized Health Care Education/Training Program

Interoperability endpoints

  • Direct secure messaging: alexandra.moody@hca3.eclinicaldirectplus.com

NPI Registry JSON

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

{
    "created_epoch": "1526083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688601600000",
    "number": "1629568977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5050 E GRANITE CLIFFS RD",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840926221",
            "telephone_number": "801-680-2964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 E HAMPDEN AVE",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801132702",
            "telephone_number": "801-680-9182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOODY",
        "first_name": "ALEXANDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-12",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CO",
            "license": "TL0009554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEXI",
            "last_name": "MOODY",
            "credential": "DO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Englewood, CO

Sources for this page

Verify at the official NPI Registry.