Active NPI
Krista Moore
- Occupational Therapist
- Woodbury, MN
National Provider Identifier
1144550914
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 101859
- Practice address
- 6909 Ashwood Rd
Apt 101
Woodbury, MN 55125-1289 - Phone
- (651) 757-0864
- NPI assigned
- Dec 30, 2009
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 101859 | MN | Primary |
Addresses
Primary practice location
6909 Ashwood Rd
Apt 101
Woodbury, MN 55125-1289
Mailing address
6909 Ashwood Rd
Apt 101
Woodbury, MN 55125-1289
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 |
|---|---|---|---|
| 101859 | MN | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1262131200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407024000000",
"number": "1144550914",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6909 ASHWOOD RD",
"address_2": "APT 101",
"city": "WOODBURY",
"state": "MN",
"postal_code": "551251289"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6909 ASHWOOD RD",
"address_2": "APT 101",
"city": "WOODBURY",
"state": "MN",
"postal_code": "551251289",
"telephone_number": "651-757-0864"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "KRISTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-12-30",
"last_updated": "2014-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MN",
"license": "101859",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodbury, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.