Theodore Nathaniel Moser, LMT, CPMT II, CIMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

9911-MT-MT Issued in MA

Practice address

187 Russell St
Hadley, MA 01035-9521

Phone

(413) 522-0658

NPI assigned

Sep 6, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Matrix Myofascial

  • Massage Therapist
  • Hadley, MA
  • NPI 1134647456
  NPD (past) Authorized official

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

{
    "created_epoch": "1504656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504656000000",
    "number": "1063930329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "678 BERNARDSTON RD",
            "city": "GREENFIELD",
            "state": "MA",
            "postal_code": "013011104",
            "telephone_number": "413-522-0658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "187 RUSSELL ST",
            "city": "HADLEY",
            "state": "MA",
            "postal_code": "010359521",
            "telephone_number": "413-522-0658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSER",
        "first_name": "THEODORE",
        "middle_name": "NATHANIEL",
        "name_prefix": "Mr.",
        "credential": "LMT, CPMT II, CIMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-09-06",
        "last_updated": "2017-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MA",
            "license": "9911-MT-MT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DIVISION OF PROFESSIONAL LICENSURE, BOARD OF REGISTRATION OF MASSA",
            "identifier": "9911-MT-MT",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Jeffrey Howard Moss, DDS, CNS, DACBN
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• New England Health and Clinical Services Inc.
• New England Health and Clinical Services Inc.

• Massage Therapist in Hadley, MA
• Providers in Hadley, MA by specialty
• Massage Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2017; 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.