NPIMap

Organization Active NPI

Explore Engage Enjoy

  • Pediatric Occupational Therapist
  • Roseburg, OR
National Provider Identifier
1073212924
Registry record updated Mar 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
Legal business name
EXPLORE ENGAGE ENJOY
Practice address
2198 NE Stephens St Ste 101
Roseburg, OR 97470-1410
Phone
(541) 900-1418
Fax
(541) 900-1419
NPI assigned
Mar 1, 2023
Last updated
Mar 1, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2023

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

Authorized official

Name
Rebecca Irene Moyer, MOTR/LNPI 1134568629
Title
Executive Directory
Phone
(541) 680-6360

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251P0200X
Pediatric Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XP0200X Primary
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X

Addresses

Primary practice location

2198 NE Stephens St Ste 101
Roseburg, OR 97470-1410

Mailing address

2198 NE Stephens St Ste 101
Roseburg, OR 97470-1410
Phone (541) 900-1418

Other identifiers 1

IdentifierTypeStateIssuer
1134568629MedicaidOR

National Provider Directory

National Provider Directory

Locations

2198 NE Stephens St
Ste 101
Roseburg, OR 97470
Phone (541) 900-1418

2405 NE Diamond Lake Blvd
Ste 75
Roseburg, OR 97470

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1677628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677628800000",
    "number": "1073212924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2198 NE STEPHENS ST STE 101",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974701410",
            "telephone_number": "541-900-1418",
            "fax_number": "541-900-1419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2198 NE STEPHENS ST STE 101",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974701410",
            "telephone_number": "541-900-1418",
            "fax_number": "541-900-1419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXPLORE ENGAGE ENJOY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-01",
        "last_updated": "2023-03-01",
        "certification_date": "2023-02-28",
        "status": "A",
        "authorized_official_last_name": "MOYER",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "IRENE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTORY",
        "authorized_official_telephone_number": "541-680-6360",
        "authorized_official_credential": "MOTR/L"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1134568629",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseburg, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2023; 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.