Active NPI
Dianne Louise Moore, OTR
- Occupational Therapist
- Venice, FL
National Provider Identifier
1003971615
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 3289
- Practice address
- 256 Nokomis Ave S Ste 2
Venice, FL 34285-2357 - Phone
- (941) 484-1939
- Fax
- (941) 484-7804
- NPI assigned
- Dec 26, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 3289 | FL | Primary |
Addresses
Primary practice location
256 Nokomis Ave S Ste 2
Venice, FL 34285-2357
Mailing address
4994 Nautilus Rd
Venice, FL 34293-7732
Phone (941) 492-2092
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3289 | FL | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida West Coast Physical Therapy & Rehabilitation Center Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Therapy Clinic/Center
- Venice, FL
- NPI 1033257670
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1253059200000",
"number": "1003971615",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4994 NAUTILUS RD",
"city": "VENICE",
"state": "FL",
"postal_code": "342937732",
"telephone_number": "941-492-2092"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "256 NOKOMIS AVE S STE 2",
"city": "VENICE",
"state": "FL",
"postal_code": "342852357",
"telephone_number": "941-484-1939",
"fax_number": "941-484-7804"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "DIANNE",
"middle_name": "LOUISE",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-26",
"last_updated": "2009-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "FL",
"license": "3289",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Venice, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.