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Grant Herron Moody

Hospitalist

Allopathic & Osteopathic Physicians

450 Northside Cherokee Blvd, Canton, GA 30115-8015

PECOS Enrollment

This provider is enrolled in PECOS as GRANT MOODY.

Based on the most recent information from CMS, provider Grant Herron Moody is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 9:43 AM.

Profile Details

Provider ID
1235666298
Provider Type
Individual
Full Name
Moody, Grant Herron
Credential
MD

Gender
Male
Sole Proprietor
No
Enumeration Date
5/21/2017
Last Updated
7/12/2023

Contact Information

Practice Location

450 Northside Cherokee Blvd, Canton, GA 30115-8015

(770) 224-1000

(770) 224-2451

Mailing Location

450 Northside Cherokee Blvd, Canton, GA 30115-8015

(770) 224-1000

(770) 224-2451

Provider Taxonomies

Code	Description	License
Code 208M00000X Primary	Description Hospitalist Allopathic & Osteopathic Physicians	License 95843 Georgia
Code 208M00000X	Description Hospitalist Allopathic & Osteopathic Physicians	License 38192 Alabama

Grant Herron Moody

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

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