Charles Bruce Moomey Jr., MD

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

049923 Issued in GA

Practice address

725 Jesse Jewell Pkwy SE
Gainesville, GA 30501-3834

Phone

(678) 207-4000

Fax

(770) 531-2435

NPI assigned

Jul 7, 2005

Last updated

Jun 11, 2025By the provider in NPPES

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 2

Medicare fee-for-service enrollment

Enrolled in GA

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

Vascular SurgeryAlso: General Surgery

Education

University of Tennessee, HSC, College of Medicine, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Longstreet Clinic, PCGroup PAC ID 2668465733, 140 clinicians

Northeast Georgia Community Physicians LLCGroup PAC ID 3274010582, 129 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Enhabit Home Health Home health agency, Gainesville, GA, CCN 117021
• Northeast Georgia Medical Center, Inc Hospital, Gainesville, GA, CCN 110029
• Northside Hospital Gwinnett Hospital, Lawrenceville, GA, CCN 110087
• Northside Hospital Duluth Hospital, Duluth, GA, CCN 110252

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: charles.moomey@longstreetclinic.gadirect.net

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

• Northeast Georgia Community Physicians LLC

  dba Longstreet of NGHS

  • Internal Medicine Physician
  • Gainesville, GA
  • NPI 1881583730
  Medicare reassignment Care Compare group NPD
• The Longstreet Clinic, PC

  • Internal Medicine Physician
  • Gainesville, GA
  • NPI 1326019977
  Medicare reassignment Care Compare group NPD
• Phoebe Physician Group, Inc

  • Clinic/Center
  • Albany, GA
  • NPI 1487899464
  Medicare reassignment NPD
• SGMC Physician Network Inc

  • Multi-Specialty Clinic/Center
  • Valdosta, GA
  • NPI 1417597170
  Medicare reassignment
• The Longstreet Clinic PC

  • Prosthetic/Orthotic Supplier
  • Gainesville, GA
  • NPI 1053422428
  NPD
• Wallace F. Martin, M.D.

  • Surgery Physician
  • Lawrenceville, GA
  • NPI 1124225065
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Caresouth HHA Holdings of Gainesville, LLC

  dba Enhabit Home Health

  • Home Health Agency
  • Gainesville, GA
  • NPI 1235117581
  Care Compare affiliation
• Northeast Georgia Medical Center, Inc.

  • General Acute Care Hospital
  • Gainesville, GA
  • NPI 1427055821
  Care Compare affiliation
• Northside Hospital, Inc.

  dba Northside Hospital Duluth

  • General Acute Care Hospital
  • Duluth, GA
  • NPI 1790715381
  Care Compare affiliation
• Northside Hospital, Inc.

  dba Northside Hospital Gwinnett

  • General Acute Care Hospital
  • Lawrenceville, GA
  • NPI 1952340994
  Care Compare affiliation

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749600000000",
    "number": "1689671364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 658",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305030658",
            "telephone_number": "770-718-1122",
            "fax_number": "770-533-4786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 JESSE JEWELL PKWY SE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013834",
            "telephone_number": "678-207-4000",
            "fax_number": "770-531-2435"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "541 Historic Hwy 441-N",
            "address_purpose": "LOCATION",
            "city": "Demorest",
            "state": "GA",
            "postal_code": "305350037",
            "country_code": "US",
            "telephone_number": "678-207-4000",
            "fax_number": "770-531-2435",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "316 N Broad St",
            "address_purpose": "LOCATION",
            "city": "Winder",
            "state": "GA",
            "postal_code": "306802150",
            "country_code": "US",
            "telephone_number": "678-207-4000",
            "fax_number": "770-531-2435",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1400 River Pl",
            "address_purpose": "LOCATION",
            "city": "Braselton",
            "state": "GA",
            "postal_code": "305175600",
            "country_code": "US",
            "telephone_number": "678-207-4000",
            "fax_number": "770-531-2435",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 Medical Center Blvd",
            "address_purpose": "LOCATION",
            "city": "Lawrenceville",
            "state": "GA",
            "postal_code": "300467694",
            "country_code": "US",
            "telephone_number": "678-207-4000",
            "fax_number": "770-531-2435",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "743 Spring St NE",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "GA",
            "postal_code": "305013715",
            "country_code": "US",
            "telephone_number": "678-207-4000",
            "fax_number": "770-531-2435",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "631 Professional Dr",
            "address_purpose": "LOCATION",
            "city": "Lawrenceville",
            "state": "GA",
            "postal_code": "300463367",
            "country_code": "US",
            "telephone_number": "678-204-4000",
            "fax_number": "678-207-4307",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3620 Howell Ferry Rd",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "GA",
            "postal_code": "300963178",
            "country_code": "US",
            "telephone_number": "678-207-4000",
            "fax_number": "770-531-2435",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1120 Peachtree Industrial Blvd",
            "address_purpose": "LOCATION",
            "city": "Suwanee",
            "state": "GA",
            "postal_code": "300242322",
            "country_code": "US",
            "telephone_number": "678-207-4620",
            "fax_number": "678-207-4307",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1270 Friendship Rd",
            "address_purpose": "LOCATION",
            "city": "Braselton",
            "state": "GA",
            "postal_code": "305175608",
            "country_code": "US",
            "telephone_number": "678-207-4000",
            "fax_number": "678-207-4071",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "801 Austin Dr",
            "address_purpose": "LOCATION",
            "city": "Demorest",
            "state": "GA",
            "postal_code": "305354513",
            "country_code": "US",
            "telephone_number": "678-207-4000",
            "fax_number": "770-531-2435",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "495 Highway 400",
            "address_purpose": "LOCATION",
            "city": "Dahlonega",
            "state": "GA",
            "postal_code": "305336823",
            "country_code": "US",
            "telephone_number": "678-207-4000",
            "fax_number": "770-531-2435",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "835 Austin Dr",
            "address_purpose": "LOCATION",
            "city": "Demorest",
            "state": "GA",
            "postal_code": "305354513",
            "country_code": "US",
            "telephone_number": "678-207-4000",
            "fax_number": "770-531-2435",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOOMEY",
        "first_name": "CHARLES",
        "middle_name": "BRUCE",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2025-06-11",
        "certification_date": "2025-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "GA",
            "license": "049923",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "GRP7416",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00899951A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Judith Mondesir, LCSW
• Travis Aaron Monk, PT, DPT
• Brandi Nichelle Monroe, PA
• Sally A. Monroe, CNM
• Sherri Toney Moody, PNP-AC
• Brian Thomas Moore, PT, DPT
• Cynthia Ann Moore, MD
• Denika L Moore, LD CPS FPM
• Derek Ronald Moore, MD
• Donna A Moore, APRN-C, PMHNP-BC, MS

• Vascular Surgery Physician in Gainesville, GA
• Providers in Gainesville, GA by specialty
• Vascular Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2025; 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.