Michael Nicholas Moulton, DO

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

DO2072 Issued in ME

Practice address

340 Boatner Rd
Eglin Afb, FL 32542-1391

Phone

(850) 883-8600

NPI assigned

Mar 29, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ME

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 Osteopathy

State licenses

Interoperability endpoints

• Direct secure messaging: michael.moulton.1@29601.direct.athenahealth.com

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

{
    "created_epoch": "1522281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724025600000",
    "number": "1962907071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 BOATNER RD",
            "city": "EGLIN AFB",
            "state": "FL",
            "postal_code": "325421391",
            "telephone_number": "850-883-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 BOATNER RD",
            "city": "EGLIN AFB",
            "state": "FL",
            "postal_code": "325421391",
            "telephone_number": "850-883-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOULTON",
        "first_name": "MICHAEL",
        "middle_name": "NICHOLAS",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-29",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ME",
            "license": "DO2972",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "ME",
            "license": "DO2072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elyzabeth Morales, CNM, DNP
• Hannah Morehouse, MD
• Chelsea Morin
• Elissa B Morrow, LCSW
• Lydia Ann Moss
• Toni Lee Mowrer
• Baron T Mullis, MD
• Tylan Muncy, MD
• Nicholas J Myers, M.D.
• Trichinopoly Ramaswamy Narayanaswamy, MD

• Cardiovascular Disease Physician in Eglin Afb, FL
• Providers in Eglin Afb, FL by specialty
• Cardiovascular Disease Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; 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.