KIRK TRACY MOSS (NPI# 1396713194) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396713194 |
| Entity Type | Individual |
| Full Name | KIRK TRACY MOSS |
| Credential | M.D. |
| Practice Address |
14th Mdg 201 Independence Dr Columbus Afb MS 39710 |
| Mailing Address |
14th Mdg, 201 Independence Drive, Bldg 1100 Columbus Afb, Ms 39710 Fpo AA 93246 |
| Practice Telephone | 6624342273 |
| Mailing Telephone | 66243439710 |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2016-10-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 31364 | AZ | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | 2838 | AK | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | MD2838 | 05 | |
| BLUE CROSS SUB | A0348 | 01 |
| Street Address |
14TH MDG 201 INDEPENDENCE DR |
| City | COLUMBUS AFB |
| State | MS |
| Zip Code | 39710 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558653063 | Steven Thomas Fosmire | Preventive Medicine | 14th Medical Group, 201 Independence Dr., Ste 2255, Columbus Afb, MS 39710 | 2011-05-03 |
| 1457311573 | Benjamin Jordan Franklin | Optometrist | 14 Medical Group, 201 Independence Dr Ste 235, Columbus Afb, MS 39710 | 2006-03-24 |
| 1659367266 | Paul H Nelson | Family Medicine | 201 Independence Dr, 14th Medical Group Ste 235, Columbus Afb, MS 39710 | 2005-09-20 |
| 1467447201 | James Henry Heriot | Internal Medicine | 201 Independence Drive, 14th Medical Group/sgoq, Columbus Afb, MS 39710 | 2005-09-19 |
| 1699372938 | Stacie Lynn Penkova | Pharmacist | 14th Medical Group, 201 Independence Drive, Columbus Afb, MS 39710 | 2020-10-08 |
| 1932696713 | James Tyler Bates | Family Medicine | 201 Independence, Columbus, MS 39710 | 2018-04-17 |
| 1972964591 | Lauren Beers | Physical Therapist | 201 Independence, Columbus, MS 39710 | 2016-03-09 |
| 1558740019 | William Jennings Amador | Family Medicine | 201 Independence Drive, 14th Medical Group, Columbus Afb, MS 39710 | 2015-05-29 |
| 1992117378 | Jennifer Bryant Williams | Social Worker | 201 Independence, Columbus, MS 39710 | 2014-05-20 |
| 1225457534 | Kenneth Richard Taylor | Preventive Medicine | 14th Medical Group, 201 Independence Drive, Columbus Afb, MS 39710 | 2014-04-15 |
| Find all providers in zip 39710 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659367266 | Paul H Nelson | Family Medicine | 201 Independence Dr, 14th Medical Group Ste 235, Columbus Afb, MS 39710 | 2005-09-20 |
| 1558740019 | William Jennings Amador | Family Medicine | 201 Independence Drive, 14th Medical Group, Columbus Afb, MS 39710 | 2015-05-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952900581 | Maegan Cook Bridges | Family Medicine | 312 Ridge Pointe Dr, Brandon, MS 39042-5035 | 2020-10-24 |
| 1003415266 | Christian Fortenberry | Family Medicine | 786 Lake Harbour Dr, Ridgeland, MS 39157-4303 | 2020-10-20 |
| 1457967226 | Tiffine Lynn Prisock | Family Medicine | 24978 Ms-15, Mathiston, MS 39752 | 2020-09-17 |
| 1851902860 | Jasmine Lester | Family Medicine | 538 Getwell Rd S, Hernando, MS 38632-9585 | 2020-08-12 |
| 1942810569 | Ericka Marcene Williams | Family Medicine | 1031 Northridge Rd Ste A, Baldwyn, MS 38824-1173 | 2020-08-07 |
| 1316557986 | Independent Healthcare Management, Inc | Family Medicine | 376 Simpson Highway 149 Ste 600, Magee, MS 39111-3572 | 2020-08-07 |
| 1164031373 | Rohith Reddy Guduru Venkata | Family Medicine | Delta Regional Medical Center, 1400 E Union St, Greenville, MS 38703 | 2020-07-24 |
| 1831707470 | Rebecca Holmes | Family Medicine | 42 Atley Holmes Rd # Rs, Jayess, MS 39641-8272 | 2020-07-20 |
| 1497373344 | Dhruval Patel | Family Medicine | 564 Cypress Ln Apt 11d, Greenville, MS 38701-7415 | 2020-07-08 |
| 1881211258 | Tiffany Chapman | Family Medicine | 905 S Frontage Rd, Meridian, MS 39301-6113 | 2020-07-01 |
| Find all providers with the same taxonomy | ||||
| City | COLUMBUS AFB |
| Zip Code | 39710 |
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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.