Individual provider Active NPI

Sara Moulder, OTR/L

  • Occupational Therapist
  • Lexington, KY
National Provider Identifier
1124590823
Registry record updated Dec 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
175083 Issued in KY
Practice address
2050 Versailles Rd
Lexington, KY 40504-1405
Phone
(859) 254-5701
NPI assigned
Dec 19, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2018

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 175083 KY Primary

Addresses

Primary practice location

2050 Versailles Rd
Lexington, KY 40504-1405

Mailing address

4192 Palmetto Dr
Lexington, KY 40513-1303
Phone (859) 684-5311

Other practice location 1

200 Whispering Brook Dr
Nicholasville, KY 40356-8892
Phone (859) 321-2741

Other practice location 2

2531 Old Rosebud Rd
Lexington, KY 40509-4574
Phone (859) 543-0337

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

LicenseStateTypeSpecialty
175083KYMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1545177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545177600000",
    "number": "1124590823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4192 PALMETTO DR",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405131303",
            "telephone_number": "859-684-5311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 VERSAILLES RD",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405041405",
            "telephone_number": "859-254-5701"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Whispering Brook Dr",
            "address_purpose": "LOCATION",
            "city": "Nicholasville",
            "state": "KY",
            "postal_code": "403568892",
            "country_code": "US",
            "telephone_number": "859-321-2741",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2531 Old Rosebud Rd",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405094574",
            "country_code": "US",
            "telephone_number": "859-543-0337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOULDER",
        "first_name": "SARA",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-19",
        "last_updated": "2018-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "KY",
            "license": "175083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2018; 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.