Active NPI
Justin Moyer, PT, DPT
- Orthopedic Physical Therapist
- Wellsville, NY
National Provider Identifier
1093910523
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- 028602-1
- Practice address
- 191 N Main St
Wellsville, NY 14895-1150 - Phone
- (585) 596-4011
- Fax
- (585) 596-4012
- NPI assigned
- Jun 15, 2007
- 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 |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | 028602-1 | NY | Primary |
Addresses
Primary practice location
191 N Main St
Wellsville, NY 14895-1150
Mailing address
8411 Route 305
Belfast, NY 14711-8639
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 |
|---|---|---|---|
| 028602-1 | NY | MD | Orthopedic Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181865600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1093910523",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8411 ROUTE 305",
"city": "BELFAST",
"state": "NY",
"postal_code": "147118639"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "191 N MAIN ST",
"city": "WELLSVILLE",
"state": "NY",
"postal_code": "148951150",
"telephone_number": "585-596-4011",
"fax_number": "585-596-4012"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOYER",
"first_name": "JUSTIN",
"name_prefix": "Mr.",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "NY",
"license": "028602-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Wellsville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.