Walter Carl Moses III, DMD

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

3793-15 Issued in MS

Practice address

202 W Park Ave
Greenwood, MS 38930-3009

Phone

(662) 219-0044

Fax

(662) 219-0045

NPI assigned

Mar 24, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: waltermoses@nsfmc.allscriptsdirect.net

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.

• North Sunflower Medical Center

  • Family Medicine Physician
  • Cleveland, MS
  • NPI 1891705133
  Medicare reassignment NPD
• Moses Oral and Facial Surgery LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Greenwood, MS
  • NPI 1609407907
  NPD Authorized official
• North Sunflower Medical Center

  • Hospitalist Physician
  • Ruleville, MS
  • NPI 1013128644
  NPD
• North Sunflower Medical Center

  • Critical Access Hospital
  • Ruleville, MS
  • NPI 1508913609

  Oral & Maxillofacial Surgery

  NPD
• North Sunflower Medical Center

  • Durable Medical Equipment & Medical Supplies
  • Greenwood, MS
  • NPI 1730903287
  NPD

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

{
    "created_epoch": "1427155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571097600000",
    "number": "1770977134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 COUNTY ROAD 190",
            "city": "GREENWOOD",
            "state": "MS",
            "postal_code": "389306980",
            "telephone_number": "662-299-0270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 W PARK AVE",
            "city": "GREENWOOD",
            "state": "MS",
            "postal_code": "389303009",
            "telephone_number": "662-219-0044",
            "fax_number": "662-219-0045"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "840 N Oak Ave",
            "address_purpose": "LOCATION",
            "city": "Ruleville",
            "state": "MS",
            "postal_code": "387713227",
            "country_code": "US",
            "telephone_number": "662-756-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOSES",
        "first_name": "WALTER",
        "middle_name": "CARL",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-24",
        "last_updated": "2019-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "MS",
            "license": "3793-15",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07720764",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Trina Denise Moore, R.N.
• Eritiki Morris, FNP
• Moses Oral and Facial Surgery LLC
• Carol Clark Moses, FNP
• Louis J Moses, M.D.
• Wilson Moses, DMD
• Shelia Evette Moton, LCSW
• John A Moyer, CRNA
• Tracey Mullins, NP
• Richard C Murphree

• Oral & Maxillofacial Surgery (D.M.D.) in Greenwood, MS
• Providers in Greenwood, MS by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.