CANDACE JACKSON MOODY (NPI# 1619332152) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619332152 |
| Entity Type | Individual |
| Full Name | CANDACE JACKSON MOODY |
| Credential | PA-C |
| Practice Address |
1540 Sunday Dr Raleigh NC 27607 |
| Mailing Address |
1540 Sunday Dr Raleigh NC 27607-6010 |
| Practice Telephone | 9197823456 |
| Practice Fax Number | 9197831441 |
| Mailing Telephone | 9197823456 |
| Mailing Fax Number | 9197831441 |
| Enumeration Date | 2015-12-29 |
| Last Update Date | 2018-08-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609816172 | Candace E Moody | Surgery | 215 E Mansion St, Suite 3e, Marshall, MI 49068-1559 | 2006-06-06 |
| Street Address |
1540 SUNDAY DR |
| City | RALEIGH |
| State | NC |
| Zip Code | 27607 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861495905 | Dennis E Bullard | Specialist | 1540 Sunday Dr, Ste 214, Raleigh, NC 27607-6000 | 2005-05-23 |
| 1245758796 | Kristin N Jones | Physician Assistant | 1540 Sunday Dr, Raleigh, NC 27607-6010 | 2017-09-05 |
| 1639618226 | Reham Ghali | Physician Assistant | 1540 Sunday Dr, Raleigh, NC 27607-6010 | 2017-02-16 |
| 1134670193 | Triangle Neurosurgery | Specialist | 1540 Sunday Dr, Raleigh, NC 27607-6010 | 2016-10-14 |
| 1801243795 | Joan Swanson | Physician Assistant | 1540 Sunday Dr, Raleigh, NC 27607-6010 | 2016-05-20 |
| 1881052710 | Meghan Elizabeth Murphy | Nurse Practitioner | 1540 Sunday Dr, Raleigh, NC 27607-6010 | 2016-02-06 |
| 1184013435 | Thinh Nguyen | Nurse Practitioner | 1540 Sunday Dr, Raleigh, NC 27607-6010 | 2015-01-09 |
| 1245650068 | Neeja Vivek Desai | Psychiatry & Neurology | 1540 Sunday Dr, Raleigh, NC 27607 | 2014-04-19 |
| 1619395092 | Casey Victoria Farin | Psychiatry & Neurology | 1540 Sunday Dr, Raleigh, NC 27607 | 2014-04-02 |
| 1720321219 | Roxana Pourdeyhimi | Psychiatry & Neurology | 1540 Sunday Dr, Raleigh, NC 27607-6010 | 2013-04-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972093144 | Kyndra Lawson | Behavior Technician | 5121 Kingdom Way, Suite 100, Raleigh, NC 27607 | 2018-05-14 |
| 1578082905 | Margaret Roberts Bova | Dietitian, Registered | 4207 Lake Boone Trail, Suite 210, Raleigh, NC 27607 | 2017-09-18 |
| 1184141897 | Chricat Garrard | Nurse Practitioner | 4207 Lake Boone Trl Ste 200, Raleigh, NC 27607 | 2017-08-23 |
| 1487178620 | John Patrick Morton | Pharmacist | 2411 Landmark Dr, Raleigh, NC 27607 | 2017-07-31 |
| 1023538857 | Heather Margaret Mazzola | Audiologist | 7800 Lake Boone Trail, 100, Raleigh, NC 27607 | 2017-06-22 |
| 1790216984 | North Carolina Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 2411 Landmark Drive, Raleigh, NC 27607 | 2017-03-21 |
| 1558819516 | Corilin Nocito Meggitt | Nurse Practitioner | 4505 Fair Meadows Ln Ste 102, Raleigh, NC 27607 | 2016-09-19 |
| 1942757034 | Stacie Walker | Obstetrics & Gynecology | 4414 Lake Boone Trl Ste 311, Raleigh, NC 27607 | 2016-09-06 |
| 1831644533 | Alisa Smajlagic Howe | Nurse Practitioner | 4210 Lake Boone Trail, Rex Rehab & Nursing Center, Raleigh, NC 27607 | 2016-08-23 |
| 1235598632 | Yoseph Saleh | Dentist | 107 Minden Ln, Raleigh, NC 27607 | 2016-02-15 |
| Find all providers in zip 27607 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285195768 | Rebecca Lee Hill | Physician Assistant | 3100 Blue Ridge Rd Ste 103, Raleigh, NC 27612-8002 | 2019-03-27 |
| 1306300520 | Lanlen Luke Venable | Physician Assistant | 4414 Lake Boone Trl Ste 502, Raleigh, NC 27607-7521 | 2019-01-23 |
| 1942723788 | Elizabeth Grace Carmen Lee Macarthur | Physician Assistant | 10211 Alm St Ste 1200, Raleigh, NC 27617-8221 | 2017-07-24 |
| 1164969168 | Grace Klinic, LLC | Physician Assistant | 6516 Falls of Neuse Rd, 110, Raleigh, NC 27615-6847 | 2017-01-27 |
| 1982075073 | David Zuckerman | Physician Assistant | 1311 E Millbrook Rd Ofc, Raleigh, NC 27609-5473 | 2015-10-14 |
| 1649570060 | Jeffrey M Rosowski | Physician Assistant | 3320 Executive Dr Ste 222, Raleigh, NC 27609-7445 | 2010-11-02 |
| 1023332020 | Brooke Register Lilley | Physician Assistant | 6500 Creedmoor Rd., Raleigh, NC 27613 | 2010-03-18 |
| 1548582620 | Melanie Fox Langston | Physician Assistant | 7870 Alexander Promenade Pl, Raleigh, NC 27617-7350 | 2010-02-17 |
| 1184863086 | Lisa Marie Hill | Physician Assistant | 2709 Blue Ridge Rd Ste 320, Raleigh, NC 27607-6462 | 2009-02-17 |
| 1538248125 | Harry David Kurtz | Physician Assistant | 4509 Creedmoor Rd Ste 201, Raleigh, NC 27612-3813 | 2006-11-03 |
| Find all providers in RALEIGH | ||||
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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.