Individual provider Active NPI

Michael V Moss, D.C.

  • Chiropractor
  • Woodstock, GA
National Provider Identifier
1689091902
Registry record updated Mar 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR009202 Issued in GA
Practice address
180 Towne Lake Pkwy
Woodstock, GA 30188-4843
Phone
(770) 517-2240
NPI assigned
Mar 25, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR009202 GA Primary

Addresses

Primary practice location

180 Towne Lake Pkwy
Woodstock, GA 30188-4843

Mailing address

180 Towne Lake Pkwy
Woodstock, GA 30188-4843
Phone (770) 517-2240

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190509000687 TX Practitioner - Chiropractic 0547502726 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1417 S Ctr St
Arlington, TX 76010-2865
Phone (817) 718-1051

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13679TXMDProfessional Counselor
CHIR009202GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Chiropractic PLLC Chiropractor CurrentSince May 8, 2019 Accepting new patients
Healthsprout LLC Chiropractor Past Accepting new patients

Locations

1417 S Center St
Arlington, TX 76010
Phone (817) 861-5757

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1395705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395705600000",
    "number": "1689091902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 TOWNE LAKE PKWY",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301884843",
            "telephone_number": "770-517-2240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 TOWNE LAKE PKWY",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301884843",
            "telephone_number": "770-517-2240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSS",
        "first_name": "MICHAEL",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-03-25",
        "last_updated": "2014-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR009202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.