Active NPI
Javier E Moreno, OT
- Physical Rehabilitation Occupational Therapist
- Amite, LA
National Provider Identifier
1023552064
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Rehabilitation Occupational Therapist
- License
- OTT.211550
- Practice address
- 216 North 2ND Street
Amite, LA 70422 - Phone
- (985) 748-7878
- Fax
- (985) 748-2837
- NPI assigned
- Dec 9, 2016
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physical Rehabilitation Occupational Therapist | 225XP0019X | OTT.211550 | LA | Primary |
Addresses
Primary practice location
216 North 2ND Street
Amite, LA 70422
Mailing address
PO Box 398
216 North 2ND Street
Amite, LA 70422
Phone (985) 748-7878
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OTT.211550 | LA | MD | Physical Rehabilitation Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1481241600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1481241600000",
"number": "1023552064",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 398",
"address_2": "216 NORTH 2ND STREET",
"city": "AMITE",
"state": "LA",
"postal_code": "70422",
"telephone_number": "985-748-7878",
"fax_number": "985-748-2837"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "216 NORTH 2ND STREET",
"city": "AMITE",
"state": "LA",
"postal_code": "70422",
"telephone_number": "985-748-7878",
"fax_number": "985-748-2837"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORENO",
"first_name": "JAVIER",
"middle_name": "E",
"name_prefix": "Mr.",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-12-09",
"last_updated": "2016-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0019X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Physical Rehabilitation",
"state": "LA",
"license": "OTT.211550",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Amite, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.