Individual provider Active NPI

Melissa Ann Moody, M.D.

  • Psychiatry Physician
  • Charleston, WV
National Provider Identifier
1750505384
Registry record updated May 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
24328 Issued in WV
Practice address
511 Morris St
Charleston, WV 25301-1326
Phone
(304) 341-0511
Fax
(304) 525-1073
NPI assigned
Apr 13, 2007
Last updated
May 15, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 24328 WV Primary

Addresses

Primary practice location

511 Morris St
Charleston, WV 25301-1326

Mailing address

3375 US Route 60
Huntington, WV 25705-2837
Phone (304) 525-7851

Other identifiers 2

IdentifierTypeStateIssuer
0005355002MedicaidWV
3810022672MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20110809000525 WV Practitioner - Psychiatry 1850560889 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
West Virginia University School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boone Memorial Hospital IncGroup PAC ID 3375433352, shared by 8 NPIs, 78 clinicians

Practice addresses (Care Compare)

701 Madison Ave
Madison, WV 25130-1669
Phone (304) 369-1230

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Boone Memorial Hospital, Inc Current Accepting new patients
Boone Memorial Hospital, Inc CurrentSince Nov 18, 2019 Accepting new patients
Boone Memorial Hospital, Inc Current Accepting new patients
Boone Memorial Hospital, Inc CurrentSince Nov 18, 2019 Accepting new patients
Boone Memorial Hospital, Inc Psychiatry Current Accepting new patients
Boone Memorial Hospital, Inc Past Accepting new patients
Boone Memorial Hospital, Inc Past Accepting new patients

Locations

6952 Coal River Rd
#C
Comfort, WV 25049
Phone (304) 307-3116

300 4th St
Danville, WV 25053
Phone (304) 307-6201

467 Main St
Ste 3
Madison, WV 25130
Phone (304) 369-1230

660 S Main St
#A
Madison, WV 25130
Phone (304) 369-1230

701 Madison Ave
Madison, WV 25130
Phone (304) 369-1230

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337040000000",
    "number": "1750505384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3375 US ROUTE 60",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257052837",
            "telephone_number": "304-525-7851",
            "fax_number": "304-525-1073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 MORRIS ST",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253011326",
            "telephone_number": "304-341-0511",
            "fax_number": "304-525-1073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOODY",
        "first_name": "MELISSA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-13",
        "last_updated": "2012-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WV",
            "license": "24328",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0005355002",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810022672",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.