Individual provider Active NPI

Meredith H Moses, PA-C

  • Physician Assistant
  • London, KY
National Provider Identifier
1861834236
Registry record updated May 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA1820 Issued in KY
Practice address
160 London Mountain View Dr
London, KY 40741-6601
Phone
(606) 864-0770
Fax
(606) 864-1461
NPI assigned
Jul 25, 2013
Last updated
May 26, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA1820 KY Primary

Addresses

Primary practice location

160 London Mountain View Dr
London, KY 40741-6601

Mailing address

100 E Liberty St
Ste 800
Louisville, KY 40202-1434
Phone (606) 864-0770

Other identifiers 1

IdentifierTypeStateIssuer
7100262600MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131018000368 KY Practitioner - Physician Assistant 5092949453 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Trillium Way
Corbin, KY 40701-8426
Phone (954) 939-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Organizations & group practices 3

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": "1374710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432598400000",
    "number": "1861834236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E LIBERTY ST",
            "address_2": "STE 800",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021434",
            "telephone_number": "606-864-0770",
            "fax_number": "606-864-1461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 LONDON MOUNTAIN VIEW DR",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407416601",
            "telephone_number": "606-864-0770",
            "fax_number": "606-864-1461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSES",
        "first_name": "MEREDITH",
        "middle_name": "H",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-25",
        "last_updated": "2015-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA1820",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100262600",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in London, KY

Sources for this page

Verify at the official NPI Registry.