Individual provider Active NPI

Timothy Victor Moxie, P.T.

  • Physical Therapist
  • Livonia, MI
National Provider Identifier
1124258330
Registry record updated Jul 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
L1541872 Issued in MI
Practice address
37650 Professional Center Dr
Suite 105a
Livonia, MI 48154-1197
Phone
(734) 953-1745
Fax
(734) 953-1743
NPI assigned
Jul 22, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X L1541872 MI Primary

Addresses

Primary practice location

37650 Professional Center Dr
Suite 105a
Livonia, MI 48154-1197

Mailing address

37650 Professional Center Dr
Suite 105a
Livonia, MI 48154-1197
Phone (734) 953-1745

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
L1541872MIMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1248220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248220800000",
    "number": "1124258330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37650 PROFESSIONAL CENTER DR",
            "address_2": "SUITE 105A",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481541197",
            "telephone_number": "734-953-1745",
            "fax_number": "734-953-1743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37650 PROFESSIONAL CENTER DR",
            "address_2": "SUITE 105A",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481541197",
            "telephone_number": "734-953-1745",
            "fax_number": "734-953-1743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOXIE",
        "first_name": "TIMOTHY",
        "middle_name": "VICTOR",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-22",
        "last_updated": "2009-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "L1541872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2009; 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.