Active NPI
John D Moynehan, LMFT
- Marriage & Family Therapist
- Wakefield, RI
National Provider Identifier
1083773626
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFT00108
- 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, 2008
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 32219 | Other | RI | BLUE CROSS BLUE SHIELD OF RI |
| 1020890 | Other | RI | NEIGHBORHOOD 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
| License | State | Type | Specialty |
|---|---|---|---|
| MFT00108 | RI | MD | Marriage & 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.