Individual provider Active NPI

Neil Franklin Moody Jr., PA-C

  • Physician Assistant
  • Killeen, TX
National Provider Identifier
1962548685
Registry record updated Jan 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA10004174 Issued in WA
Practice address
2301 S Clear Creek Rd
Suite 206
Killeen, TX 76549-4143
Phone
(254) 628-5454
Fax
(254) 628-2729
NPI assigned
Jan 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA10004174 WA Primary
Physician Assistant 363A00000X TX

Addresses

Primary practice location

2301 S Clear Creek Rd
Suite 206
Killeen, TX 76549-4143

Mailing address

PO Box 938
Killeen, TX 76540-0938
Phone (254) 245-9045

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20160427001376 WA Practitioner - Physician Assistant 4486883535 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians

Practice addresses (Care Compare)

311 S L St
Tacoma, WA 98405-3720

4700 Point Fosdick Dr
Gig Harbor, WA 98335-1706

Hospital & facility affiliations

  • Tacoma General Allenmore Hospital Hospital, Tacoma, WA, CCN 500129
  • Multicare Covington Medical Center Hospital, Covington, WA, CCN 500154

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA10004174WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince May 1, 2016 Accepting new patients
Multicare Health System Physician Assistant CurrentSince May 1, 2016 Accepting new patients
Arthritis Consultants, PA Past Accepting new patients
Multicare Health System Physician Assistant Past Accepting new patients

Locations

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

1901 S Cedar St
Ste 201
Tacoma, WA 98405
Phone (253) 272-2261

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

Interoperability endpoints

  • Direct secure messaging: mneil219710@direct.multicare.org

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389830400000",
    "number": "1962548685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 938",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765400938",
            "telephone_number": "254-245-9045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 S CLEAR CREEK RD",
            "address_2": "SUITE 206",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765494143",
            "telephone_number": "254-628-5454",
            "fax_number": "254-628-2729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOODY",
        "first_name": "NEIL",
        "middle_name": "FRANKLIN",
        "name_suffix": "Jr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2014-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10004174",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Killeen, TX

Sources for this page

Verify at the official NPI Registry.