Individual provider Active NPI

Josiah Moulton, D.O.

  • Family Medicine Physician
  • Longview, TX
National Provider Identifier
1942640875
Registry record updated Aug 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
T6652 Issued in TX
Practice address
1005 N Eastman Rd
Longview, TX 75601-4231
Phone
(903) 247-8262
NPI assigned
Jun 25, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 11505690-1205 UT
Family Medicine Physician 207Q00000X 125.063892 IL
Adult Medicine Physician 207QA0505X 1294 NE
Family Medicine Physician 207Q00000X T6652 TX Primary

Addresses

Primary practice location

1005 N Eastman Rd
Longview, TX 75601-4231

Mailing address

1005 N Eastman Rd
Longview, TX 75601-4231
Phone (903) 247-8262

Other practice location 1

905 N 1000 W
Tremonton, UT 84337-9356
Phone (435) 207-4500

Other practice location 2

3712 Scotsdale Dr
Swansea, IL 62226-7589
Phone (801) 310-7145

Other practice location 3

7321 Balmer St
Hill AFB, UT 84056-5012
Phone (801) 586-9596

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20201216002710 UT Practitioner - Family Practice 7315240710 Reassigns benefits to 2 organizations
I20220803002497 TX Practitioner - Family Practice 7315240710 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1294NEMDRegistered Dietitian
125.063892ILMDFamily Medicine Physician
T6652TXMDFamily Medicine Physician
11505690-1205UTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc Family Medicine CurrentSince Sep 16, 2020 Accepting new patients
Ihc Health Services Inc Family Medicine Current Accepting new patients
Ihc Health Services, Inc. CurrentSince Sep 16, 2020 Accepting new patients
Ihc Health Services Inc CurrentSince Jan 26, 2022 Accepting new patients
Concord Medical Group of Texas PLLC CurrentSince Jun 15, 2022 Accepting new patients
East Texas Medical Services PLLC CurrentSince May 15, 2023 Accepting new patients
Concord Medical Group PLLC CurrentSince Jun 15, 2022 Accepting new patients
Ihc Health Services Inc Current Accepting new patients

Locations

200 S Geneva St
Breckenridge, TX 76424
Phone (254) 559-2241

310 W South St
Henrietta, TX 76365
Phone (806) 647-2191

2001 N Jefferson Ave
Mt Pleasant, TX 75455
Phone (903) 434-8044

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

1380 E Medical Center Dr
St George, UT 84790
Phone (435) 251-2992

1380 E Medical Center Dr
#P
St George, UT 84790
Phone (435) 251-2355

905 N 1000 W
Tremonton, UT 84337
Phone (435) 207-4500

Interoperability endpoints

  • Direct secure messaging: josiah.moulton@206928471916548.direct.elationemr.com

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1372118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756425600000",
    "number": "1942640875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 N EASTMAN RD",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756014231",
            "telephone_number": "903-247-8262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 N EASTMAN RD",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756014231",
            "telephone_number": "903-247-8262"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "905 N 1000 W",
            "address_purpose": "LOCATION",
            "city": "Tremonton",
            "state": "UT",
            "postal_code": "843379356",
            "country_code": "US",
            "telephone_number": "435-207-4500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3712 Scotsdale Dr",
            "address_purpose": "LOCATION",
            "city": "Swansea",
            "state": "IL",
            "postal_code": "622267589",
            "country_code": "US",
            "telephone_number": "801-310-7145",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7321 Balmer St",
            "address_purpose": "LOCATION",
            "city": "Hill AFB",
            "state": "UT",
            "postal_code": "840565012",
            "country_code": "US",
            "telephone_number": "801-586-9596",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOULTON",
        "first_name": "JOSIAH",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-25",
        "last_updated": "2025-08-29",
        "certification_date": "2025-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "11505690-1205",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125.063892",
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "NE",
            "license": "1294",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "T6652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

Verify at the official NPI Registry.