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MOSS STREET MEDICAL CLINIC INC
NPI 1417085192
Physician Assistant - Medical in Lafayette, LA

Active since March 02, 2007
1417 MOSS ST, LAFAYETTE, LA 70501(337) 232-3371(337) 232-3511 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Moss Street Medical Clinic Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MOSS STREET MEDICAL CLINIC INC (NPI 1417085192) is a healthcare organization registered as a medical in Lafayette, Louisiana and active in the NPI registry since March 2007. The organization lists Rickie Edward Johnson, Owner, as its authorized official.

NPPES Registry Identity

NPI1417085192
Entity TypeOrganization
Primary Taxonomy363AM0700X
Legal Business NameMOSS STREET MEDICAL CLINIC INC
Location Address1417 MOSS STLafayette, LA 70501-3654
Mailing Address1417 Moss StLafayette, LA 70501-3654 · (337) 232-3371 · Fax (337) 232-3511
Phone(337) 232-3371
Fax(337) 232-3511
Organization SubpartNo
Authorized OfficialRickie Edward JohnsonOwner · (337) 232-3371
Enumeration DateMarch 2, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1417085192 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in LA · A10226
1417 MOSS ST, Lafayette, LA 70501
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Other Identifiers 1

Medicaid1448397LA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Moss Street Medical Clinic Inc's NPI number?

The NPI number for Moss Street Medical Clinic Inc is 1417085192. It was assigned to this organization in the NPPES registry on March 2, 2007.

Where is Moss Street Medical Clinic Inc located?

Moss Street Medical Clinic Inc is located at 1417 Moss St, Lafayette, LA 70501. The listed phone number is (337) 232-3371.

What is Moss Street Medical Clinic Inc's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

When was this NPI record last updated?

The NPPES record for Moss Street Medical Clinic Inc was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.