Charles B Moomey Jr MD

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

049923 Issued in GA

Legal business name

CHARLES B MOOMEY JR MD

Practice address

631 Professional Drive
Suite 300
Lawrenceville, GA 30046-3371

Phone

(770) 962-9977

Fax

(770) 339-9804

NPI assigned

Jul 2, 2007

Last updated

Sep 1, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Charles Bruce Moomey Jr., M.D.

Title

Owner

Phone

(770) 962-9977

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sudhindra K Anegundi, MD

  • Vascular Surgery Physician
  • Lawrenceville, GA
  • NPI 1629039052
  NPD (past)
• James Kevin Elsey, M.D.

  • Vascular Surgery Physician
  • Lawrenceville, GA
  • NPI 1932107349
  NPD (past)
• Gregory P Schlegel, MD

  • Surgery Physician
  • Lawrenceville, GA
  • NPI 1518010313
  NPD (past)
• David Robert Schmidt, MD

  • Surgery Physician
  • Lawrenceville, GA
  • NPI 1366440992
  NPD (past)
• Leo L. Fong, MD

  • Vascular Surgery Physician
  • Clovis, CA
  • NPI 1215047659
  NPD (past)

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

{
    "created_epoch": "1183334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283299200000",
    "number": "1902003841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 PROFESSIONAL DRIVE",
            "address_2": "SUITE 300",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300463371",
            "telephone_number": "770-962-9977",
            "fax_number": "770-339-9804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 PROFESSIONAL DRIVE",
            "address_2": "SUITE 300",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300463371",
            "telephone_number": "770-962-9977",
            "fax_number": "770-339-9804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES B MOOMEY JR MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-02",
        "last_updated": "2010-09-01",
        "status": "A",
        "authorized_official_last_name": "MOOMEY",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "BRUCE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-962-9977",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "GA",
            "license": "049923",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00899951A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• I-Wen Chang, M.D.
• Kate Chang
• Margaret Y. Chang, M.D.
• Donald Chapman, D.O
• Rukshar Charania, RN
• Andrea Marie Charnock, CAA
• Jesse Chase, PTA
• Chasing Balanced Wellness, LLC
• Crystal Lynn Chastain, CNP
• Lauren Nicole Chatham, M.D.

• Vascular Surgery Physician in Lawrenceville, GA
• Providers in Lawrenceville, 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 Sep 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.