Jason Ellis Moore, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT.006728 Issued in OH

Practice address

35 Edmar Ave
Marietta, OH 45750-7603

Phone

(740) 373-0761

NPI assigned

May 17, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093923864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 EDMAR AVE",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "457507603",
            "telephone_number": "740-373-0761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 EDMAR AVE",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "457507603",
            "telephone_number": "740-373-0761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JASON",
        "middle_name": "ELLIS",
        "name_prefix": "Mr.",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OH",
            "license": "OT.006728",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WV",
            "license": "1318",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Moat, OTR/L
• Dreama Mongeau
• Traci Lynn Monroe, RN
• David Montgomery, D.O.
• Tamara Montgomery, D.O.
• Kevin Moore, MD
• Kirby L Moore, B.S., A.T.,C.
• Madison Blaze Moore
• Casey R Morehead
• Pamela Jean Morehead, LPTA

• Occupational Therapist in Marietta, OH
• Providers in Marietta, OH by specialty
• Occupational Therapist in Ohio

• 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.

Verify at the official NPI Registry.