Active NPI
Jessica Moultrie
- Physical Therapy Assistant
- Memphis, TN
National Provider Identifier
1033540679
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PTA0000003986
- Practice address
- 1195 Wellsville Rd
Memphis, TN 38117-5941 - Phone
- (901) 692-8139
- NPI assigned
- Dec 9, 2013
- 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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | PTA0000003986 | TN | Primary |
Addresses
Primary practice location
1195 Wellsville Rd
Memphis, TN 38117-5941
Mailing address
1195 Wellsville Rd
Memphis, TN 38117
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 |
|---|---|---|---|
| PTA0000003986 | TN | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1386547200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1386547200000",
"number": "1033540679",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1195 WELLSVILLE RD",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "38117"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1195 WELLSVILLE RD",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381175941",
"telephone_number": "901-692-8139"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOULTRIE",
"first_name": "JESSICA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-12-09",
"last_updated": "2013-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "TN",
"license": "PTA0000003986",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Memphis, TN
- Carol Mott-Miller, ME.D
- Maurice Mottley
- Francesco Lorenzo Mottola, PHARMD
- Racheal Kia Moua, OD
- Mohamad Khaled Moughrabieh, MD
- Keyvona Janet Moultrie, MD
- Mountain Chiropractic, PC (Presley Chiropractic)
- Mountain Chiropractic, PC (Poplar Chiropractic)
- Mountain Chiropractic, PC (Winchester Chiropractic)
- Madison Elise Mountjoy, COTA/L
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.