Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Elijah Cale Moody

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1992641146

Elijah Cale Moody is a Student in an Organized Health Care Education/Training Program in College Dale, Tennessee. Practices as a sole proprietor. Licensed in Tennessee.

Licensed in
TN
In the registry since
2026

Practice location Address checks out

5119 City Station Dr
College Dale, TN 37363-7153
Phone: (762) 294-0290
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X (TN)

Record details

NPI number1992641146
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedApril 28, 2026
Last updated in NPPESApril 28, 2026
Certification dateApril 28, 2026