MRS. JESSICA MAE MOODY PHYSICIAN ASSISTANT NPI 1043349400

NPI Information

NPI: 1043349400
Provider Name: MRS. JESSICA MAE MOODY, PHYSICIAN ASSISTANT
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
14780 W MOUNTAIN VIEW BLVD STE 110
SURPRISE, AZ
ZIP 85374
Phone: (623) 374-7774
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MRS. Jessica Mae Moody, PHYSICIAN ASSISTANT is a medical physician assistant in Surprise, AZ. MRS. Jessica Mae Moody, PHYSICIAN ASSISTANT NPI is 1043349400. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

14780 W MOUNTAIN VIEW BLVD STE 110
SURPRISE, AZ
ZIP 85374-280
Phone: (623) 374-7774

The NPI 1043349400 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/3/2007 and was last updated on 11/23/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	3474	ARIZONA	Yes
2	363AS0400X	Physician Assistant	Surgical	3474	ARIZONA	No

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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