Active NPI
Rebekah Moilanen, MT-BC
- Music Therapist
- Jackson, MI
National Provider Identifier
1053804807
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Music Therapist
- License
- 08487
- Practice address
- 1001 Laurence Ave Ste D
Jackson, MI 49202-2978 - Phone
- (517) 416-1088
- NPI assigned
- Jun 7, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Music Therapist | 225A00000X | 08487 | MI | Primary |
Addresses
Primary practice location
1001 Laurence Ave Ste D
Jackson, MI 49202-2978
Mailing address
5879 Bibon St
Jackson, MI 49201-8317
Phone (517) 914-3430
Other names 1
- Rebekah Stout
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 |
|---|---|---|---|
| 08487 | MI | MD | Music Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1528329600000",
"number": "1053804807",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5879 BIBON ST",
"city": "JACKSON",
"state": "MI",
"postal_code": "492018317",
"telephone_number": "517-914-3430"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 LAURENCE AVE STE D",
"city": "JACKSON",
"state": "MI",
"postal_code": "492022978",
"telephone_number": "517-416-1088"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOILANEN",
"first_name": "REBEKAH",
"credential": "MT-BC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-06-07",
"last_updated": "2018-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "225A00000X",
"taxonomy_group": "",
"desc": "Music Therapist",
"state": "MI",
"license": "08487",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "REBEKAH",
"last_name": "STOUT",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Jackson, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.