1174576623 NPI number — MRS. CYNTHIA MOSES PT

Table of content: MRS. CYNTHIA MOSES PT (NPI 1174576623)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174576623 NPI number — MRS. CYNTHIA MOSES PT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MOSES
Provider First Name:
CYNTHIA
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
PT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PALMERI-PARKIN
Provider Other First Name:
CYNTHIA
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
PT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1174576623
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/24/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
255 ENTERPRISE BLVD
Provider Second Line Business Mailing Address:
SUITE 250
Provider Business Mailing Address City Name:
GREENVILLE
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29615-6300
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
864-454-0888
Provider Business Mailing Address Fax Number:
864-454-1130

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3851 HOWARD GAP RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HENDERSONVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28792-3102
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
864-454-6670
Provider Business Practice Location Address Fax Number:
864-454-6675
Provider Enumeration Date:
05/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  P8677 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 225100000X , with the licence number: 5263 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 20-2312101 . This is a "SELECT HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 607756102 . This is a "DEPT OF LABOR" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: 190244 . This is a "MEDCOST" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: 20-2312101 . This is a "UHC" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: 20-2312101 . This is a "GREAT WEST" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: 20-2312101 . This is a "FOCUS" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: 20-2312101 . This is a "CHAMPUS-TRICARE" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: 20-2312101 . This is a "DEPT OF LABOR" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: 20-2312101 . This is a "KANAWHA" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: 9799717 . This is a "CIGNA" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: 20-2312101 . This is a "TAX ID" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: 607756100 . This is a "DEPT OF LABOR" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: 7761758 . This is a "AETNA" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: 20-2312101 . This is a "BLUECHOICE" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: TH1709 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 20-2312101 . This is a "BCBS OF SOUTH CAROLINA" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: 607756103 . This is a "DEPT OF LABOR" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: 20-2312101 . This is a "PREMIER" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: 20-2312101 . This is a "CAROLINA CARE PLAN" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com