Mark James Moody, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

G38627 Issued in CA

Practice address

5900 Coyle Ave
Suite a
Carmichael, CA 95608-0400

Phone

(916) 344-9400

Fax

(916) 344-9401

NPI assigned

Jan 25, 2008

Last updated

Feb 14, 2011By the provider in NPPES

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 3

Medicare fee-for-service enrollment

Enrolled in CA

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

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1201219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297641600000",
    "number": "1952588592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 COYLE AVE",
            "address_2": "SUITE A",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956080400",
            "telephone_number": "916-344-9400",
            "fax_number": "916-344-9401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 COYLE AVE",
            "address_2": "SUITE A",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956080400",
            "telephone_number": "916-344-9400",
            "fax_number": "916-344-9401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOODY",
        "first_name": "MARK",
        "middle_name": "JAMES",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-25",
        "last_updated": "2011-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G38627",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "G38627",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G386270",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1962422618",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lourdes Villanueva Moldre, RN, MSN, ACNP-BC
• Terry Lee Moler, PHARMD
• Monad Dialysis, LLC (American River Dialysis)
• Emily Montandon, RN
• Gabrielle Domonique Montgomery
• Debra Moore, PH.D.
• Kathleen Moore
• Kaylee Mora, RADTI
• Veronica Lynn Morales
• Christine Moran

• Internal Medicine Physician in Carmichael, CA
• Providers in Carmichael, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2011; 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.