KEITH J MOODY D O P C (NPI# 1295917524) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295917524 |
| Entity Type | Organization |
| Organization Name | KEITH J MOODY D O P C |
| Practice Address |
200 S Wenona St Suite 225 Bay City MI 48706-8820 |
| Practice Telephone | 9898939705 |
| Practice Fax Number | 9898938206 |
| Mailing Telephone | 9898939705 |
| Mailing Fax Number | 9898938206 |
| Enumeration Date | 2007-11-28 |
| Last Update Date | 2007-11-28 |
| Authorized Official Name | KEITH J MOODY D O (OWNER) |
| Authorized Official Telephone | 9898939705 |
| Authorized Official Credential | D O |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 5101008328 | MI | Allopathic & Osteopathic Physicians |
| Y | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
5101008328 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| HEALTH PLUS OF MI | 1150900464 | 01 | |
| PRIORITY HEALTH | 28233 | 01 | |
| MI | 4164290 | 05 | |
| MCLAREN HEALTH PLAN | 1006214 | 01 | |
| BLUE CROSS BLUE SHIELD MI | 1150900464 | 01 | |
| FEP BLUE CROSS | 1150900464 | 01 | |
| AETNA | 4220040 | 01 | |
| COMMUNITY CHOICE | 16613 | 01 | |
| BLUE CARE NETWORK | 50900464 | 01 |
| Street Address |
200 S WENONA ST SUITE 225 |
| City | BAY CITY |
| State | MI |
| Zip Code | 48706-8820 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689650103 | Margarethe M Maciulis | Internal Medicine | 200 S Wenona St, Suite 260, Bay City, MI 48706 | 2005-12-16 |
| 1235604679 | Karen Kay Tumblin | Nurse Practitioner | 200 S Wenona St, Bay City, MI 48706-8820 | 2018-10-12 |
| 1376936211 | Stephanie Leslie | Nurse Practitioner | 200 S Wenona St, Bay City, MI 48706-8820 | 2015-03-17 |
| 1073925855 | J.b. Hearing, Inc. | Hearing Instrument Specialist | 200 S Wenona St, Suite 165, Bay City, MI 48706-8820 | 2014-05-28 |
| 1073930822 | Mark Stewart Md | Orthopaedic Surgery | 200 S Wenona St, Suite G95, Bay City, MI 48706-8820 | 2014-03-18 |
| 1881934685 | Christopher E Bruck, Md | Physician Assistant | 200 S Wenona St, Suite 195, Bay City, MI 48706-8820 | 2013-02-15 |
| 1467761510 | Sheryl Hasegawa Arthur Do Pllc | Family Medicine | 200 S Wenona St, Bay City, MI 48706-8820 | 2010-10-06 |
| 1942468459 | Venkat Talasila | Counselor | 200 S Wenona St, Ste G29, Bay City, MI 48706-8820 | 2008-05-30 |
| 1134301484 | Mark E Ginther M D P C | Internal Medicine | 200 S Wenona St, Suite 225, Bay City, MI 48706-8820 | 2007-11-28 |
| 1881875763 | James A Guigelaar Md PC | Internal Medicine | 200 S Wenona St, Suite 225, Bay City, MI 48706-8820 | 2007-11-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619574357 | Kalie Keyes | Behavior Technician | 3710 Katalin Ct, Bay City, MI 48706 | 2020-10-06 |
| 1790251049 | Leann Marie Miller | Nurse Practitioner | Visiting Physicians Association, 1484 Straits Drive, Bay City, MI 48706 | 2018-10-15 |
| 1659883676 | Matthew Zamora | Internal Medicine | 4818 S Professional Dr, Bay City, MI 48706 | 2017-10-31 |
| 1376082230 | Deidre Dotson | Social Worker | 1217 S Euclid, Bay City, MI 48706 | 2017-02-13 |
| 1790100717 | Kochar Plc | Internal Medicine | 4817 E. Professional Drive, Bay City, MI 48706 | 2014-02-27 |
| 1992136477 | Janelle Gale Ballard | Music Therapist | 4106 Wilder Rd, Bay City, MI 48706 | 2013-12-09 |
| 1619319084 | Jessica T Jang | Veterinarian | 6015 West Side Saginaw Rd, Bay City, MI 48706 | 2013-07-25 |
| 1427493634 | Cynthia Marie Bordeau | Social Worker | 1217 S. Euclid, Bay City, MI 48706 | 2013-05-01 |
| 1902162746 | Delta Family Clinic South PC | Psychologist | 901 N. Euclid Ave., Bay City, MI 48706 | 2012-04-05 |
| 1669762985 | James Norbert Stachowski | Pharmacist | 3880 Wilder, Bay City, MI 48706 | 2011-04-08 |
| Find all providers in zip 48706 | ||||
| Taxonomy Code | 207RG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Geriatric Medicine |
| An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588986996 | Great Lakes Medical Center Pllc | Internal Medicine | 2110 16th Street, Ste. 4, Bay City, MI 48708 | 2010-02-26 |
| 1356370944 | Tazeen Ahmed | Internal Medicine | 2110 16th St, Ste. 4, Bay City, MI 48708-7609 | 2006-07-03 |
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| 1801371315 | Matrix Medical Pllc | Internal Medicine | 52611 Blueridge Dr, Shelby Twp, MI 48316-2977 | 2018-10-01 |
| 1407364821 | Chesaning Comfort Care | Internal Medicine | 1800 W Brady Rd, Chesaning, MI 48616 | 2018-01-19 |
| 1992252191 | Vitality Home Health Services,inc. | Internal Medicine | 917 W Milham Ave, Portage, MI 49024-1248 | 2016-09-06 |
| 1427419662 | Shoaib A Rasheed | Internal Medicine | 250 Mcdougall St, Detroit, MI 48207-4291 | 2016-03-16 |
| 1710226477 | Nancy Couch | Internal Medicine | 791 Bradburn Ct, Northville, MI 48167-1027 | 2013-01-31 |
| 1639425879 | Anhkiet L Tran | Internal Medicine | 29736 Orion Ct, Farmington Hills, MI 48334-4114 | 2012-07-25 |
| 1700152014 | Nicholas Joseph | Internal Medicine | 24463 W 10 Mile Rd, Pace Southeast Michigan, Southfield, MI 48033-2931 | 2012-03-30 |
| 1689949034 | Drs Housecalls PC | Internal Medicine | 298 S. Old Woodward, Birminham, MI 48009 | 2012-03-19 |
| 1699055269 | Mobilized Docs of Michigan LLC | Internal Medicine | 23943 Industrial Park Dr, Farmington Hills, MI 48335-2862 | 2011-08-26 |
| 1780986018 | Spectrum Health Primary Care Partners | Internal Medicine | 727 Apple Ave, Holland, MI 49423-5405 | 2010-11-18 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.