CLAIBORNE LAKE III MOSELEY (M.D.) – Orthopaedic Surgery Physician, NPI 1790772374

CLAIBORNE LAKE III MOSELEY (M.D.) is a healthcare provider. based in Jonesboro, Arkansas. specializing in Orthopaedic Surgery Physician. They hold the professional credentials M.D.. They hold a License No. N8222 (AR). The NPI Number for CLAIBORNE LAKE III MOSELEY (M.D.) is 1790772374

Main info

Male
45 Years Of Experience
Accepts Medicare Assignment
Name
CLAIBORNE LAKE III MOSELEY (M.D.)
NPI
1790772374
Phone
(870) 935-0519
Address
300 CARSON ST
Enumeration Date
29 September 2005
Last Update Date
5 April 2017

Doctor Profile

Medical School Name
UNIVERSITY OF SOUTH CAROLINA SCHOOL OF MEDICINE
Secondary Phone
8709321198
Graduation Year
1981 (45 years ago)
PAC ID
4183769847
Group Practice PAC ID
8921287087
Professional Enrollment ID
I20100326000563
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for CLAIBORNE LAKE III MOSELEY (M.D.)

  • 300, Carson Street, Jonesboro, Craighead County, Arkansas, 72401, United States

    JONESBORO, AR 724013104

    Phone: (870) 935-0519

    Fax: (870) 802-0355

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2010-03-26

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20100326000563IOrthopedic SurgeryARTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 72401)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8921287087View full group profile

Reviews

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Frequently asked questions

What is the 10-digit NPI for CLAIBORNE LAKE III MOSELEY (M.D.)?
CLAIBORNE LAKE III MOSELEY (M.D.) — NPI 1790772374 — is the standard way to identify this listing.
Is CLAIBORNE LAKE III MOSELEY (M.D.) still practicing?
CLAIBORNE LAKE III MOSELEY (M.D.) is currently listed as active in the public NPI registry.
What is CLAIBORNE LAKE III MOSELEY (M.D.) best known for clinically?
Directory data describes CLAIBORNE LAKE III MOSELEY (M.D.) with Orthopaedic Surgery Physician. Clinical services aligned with this taxonomy classification.
Does CLAIBORNE LAKE III MOSELEY (M.D.) list a practice location?
Patients near Jonesboro, Arkansas may find CLAIBORNE LAKE III MOSELEY (M.D.) in results; validate coverage separately.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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