Individual provider Active NPI

John D Moynehan, LMFT

  • Marriage & Family Therapist
  • Wakefield, RI
National Provider Identifier
1083773626
Registry record updated Jul 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFT00108 Issued in RI
Practice address
1157 South Rd
Wakefield, RI 02879-7633
Phone
(401) 789-1367
Fax
(401) 783-2558
NPI assigned
Dec 8, 2006
Last updated
Jul 15, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFT00108 RI Primary

Addresses

Primary practice location

1157 South Rd
Wakefield, RI 02879-7633

Mailing address

61 Almy St
Newport, RI 02840-1809
Phone (401) 789-1367

Other identifiers 2

IdentifierTypeStateIssuer
32219OtherRIBLUE CROSS BLUE SHIELD OF RI
1020890OtherRINEIGHBORHOOD HEALTH PLAN

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

LicenseStateTypeSpecialty
MFT00108RIMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216080000000",
    "number": "1083773626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 ALMY ST",
            "city": "NEWPORT",
            "state": "RI",
            "postal_code": "028401809",
            "telephone_number": "401-789-1367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1157 SOUTH RD",
            "city": "WAKEFIELD",
            "state": "RI",
            "postal_code": "028797633",
            "telephone_number": "401-789-1367",
            "fax_number": "401-783-2558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOYNEHAN",
        "first_name": "JOHN",
        "middle_name": "D",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-08",
        "last_updated": "2008-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "RI",
            "license": "MFT00108",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF RI",
            "identifier": "32219",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH PLAN",
            "identifier": "1020890",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wakefield, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2008; 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.