Individual provider Active NPI

John P Moran, OT

  • Occupational Therapist
  • Windham, NH
National Provider Identifier
1114068665
Registry record updated Dec 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
1194 Issued in NH
Practice address
25 Indian Rock Rd Ste 11
Windham, NH 03087-1691
Phone
(603) 952-4560
Fax
(603) 952-4561
NPI assigned
Feb 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 1194 NH Primary

Addresses

Primary practice location

25 Indian Rock Rd Ste 11
Windham, NH 03087-1691

Mailing address

25 Indian Rock Rd Ste 11
Windham, NH 03087-1691
Phone (603) 952-4560

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051230000051 NH Practitioner - Occupational Therapist in Private Practice 5991727273 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

25 Indian Rock Rd
Suite 11
Windham, NH 03087-1691
Phone (603) 952-4560

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10780MAMDClinical Psychologist
1194NHMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Performance Rehab, Inc. PastSince Apr 28, 1999 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671062400000",
    "number": "1114068665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 INDIAN ROCK RD STE 11",
            "city": "WINDHAM",
            "state": "NH",
            "postal_code": "030871691",
            "telephone_number": "603-952-4560",
            "fax_number": "603-952-4561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 INDIAN ROCK RD STE 11",
            "city": "WINDHAM",
            "state": "NH",
            "postal_code": "030871691",
            "telephone_number": "603-952-4560",
            "fax_number": "603-952-4561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAN",
        "first_name": "JOHN",
        "middle_name": "P",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-09",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NH",
            "license": "1194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Windham, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.