Individual provider Active NPI

Stormie Dee Mosimann, P. T.

  • Specialist
  • Raton, NM
National Provider Identifier
1053505248
Registry record updated Aug 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
3433 Issued in NM
Practice address
160 Hospital Dr
Raton, NM 87740-2002
Phone
(505) 445-0111
NPI assigned
Aug 30, 2007
Last updated
Aug 30, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 3433 NM Primary

Addresses

Primary practice location

160 Hospital Dr
Raton, NM 87740-2002

Mailing address

PO Box 608
Raton, NM 87740-0608
Phone (505) 445-0111

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

LicenseStateTypeSpecialty
3433NMMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rocky Mountain Physical Therapy, Inc PastSince Apr 29, 2002 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1188432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188432000000",
    "number": "1053505248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 608",
            "city": "RATON",
            "state": "NM",
            "postal_code": "877400608",
            "telephone_number": "505-445-0111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 HOSPITAL DR",
            "city": "RATON",
            "state": "NM",
            "postal_code": "877402002",
            "telephone_number": "505-445-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSIMANN",
        "first_name": "STORMIE",
        "middle_name": "DEE",
        "name_prefix": "Mrs.",
        "credential": "P. T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-30",
        "last_updated": "2007-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NM",
            "license": "3433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raton, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.