Dr Justin Dean Moody, DO | |
530 Ne Glen Oak Ave, Peoria, IL 61603-3133 | |
(309) 655-4060 | |
Not Available |
Full Name | Dr Justin Dean Moody |
---|---|
Gender | Male |
Speciality | Emergency Medicine |
Location | 530 Ne Glen Oak Ave, Peoria, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1639370489 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207P00000X | Emergency Medicine | 2008014393 (Missouri) | Secondary |
207P00000X | Emergency Medicine | AS3581875-246 (Illinois) | Primary |
Entity Name | Mercy Clinic Springfield Communities |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1245277631 PECOS PAC ID: 7416865845 Enrollment ID: O20031104000060 |
Entity Name | Mercy Hospital South |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1568481984 PECOS PAC ID: 8426962556 Enrollment ID: O20031113000592 |
Entity Name | Mercy Hospitals East Communities |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1427098169 PECOS PAC ID: 1658276811 Enrollment ID: O20031209000789 |
Entity Name | Mercy Clinic Springfield Communities |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1972771657 PECOS PAC ID: 7416865845 Enrollment ID: O20031218000354 |
Entity Name | Mercy Hospitals East Communities |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1285664177 PECOS PAC ID: 3779479019 Enrollment ID: O20040224001164 |
Entity Name | Mercy Hospital Jefferson |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1508859661 PECOS PAC ID: 1254248271 Enrollment ID: O20050518000926 |
Entity Name | Southeastern Emergency Physicians Of Memphis Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1437105277 PECOS PAC ID: 5395643209 Enrollment ID: O20060711000434 |
Entity Name | Camden Emergency Group Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1003181637 PECOS PAC ID: 2961665369 Enrollment ID: O20120523000037 |
Entity Name | Fenton Emergency Group Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1770832792 PECOS PAC ID: 4789837923 Enrollment ID: O20130121000081 |
Entity Name | Cep America Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1619332046 PECOS PAC ID: 6608056171 Enrollment ID: O20150312000325 |
Entity Name | Mercy Hospital Lincoln |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1962808733 PECOS PAC ID: 5193040020 Enrollment ID: O20150623002541 |
Entity Name | Mercy Aco Clinical Services Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1063965093 PECOS PAC ID: 6901188572 Enrollment ID: O20170117001888 |
Mailing Address | Practice Location Address |
---|---|
Dr Justin Dean Moody, DO 611 W High St, Peoria, IL 61606-1926 Ph: (309) 922-9107 | Dr Justin Dean Moody, DO 530 Ne Glen Oak Ave, Peoria, IL 61603-3133 Ph: (309) 655-4060 |
Dr. Austin Lamb, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 530 N.e. Glen Oak Avenue, Osf St. Francis, Emergency Medicine Residency Program, Peoria, IL 61637 Phone: 309-655-7257 | |
Philip A Fifield, M.D. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637 Phone: 309-655-2553 Fax: 309-655-2602 | |
Dr. Anthony J Buecker, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 221 Ne Glen Oak Ave, Peoria, IL 61636 Phone: 309-672-5500 | |
Dr. Mark Phillip Gaudio, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637 Phone: 309-655-6710 | |
Michael M Raso, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1115 N Bourland Ave, Peoria, IL 61606 Phone: 309-264-0730 | |
Ryan Newberger, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637 Phone: 248-207-2018 | |
Craig D Koch, M.D Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637 Phone: 309-655-7257 |