Individual provider Active NPI

Cassandra Lynn Moloney, OTA

  • Occupational Therapy Assistant
  • Wausau, WI
National Provider Identifier
1164190161
Registry record updated Sep 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
5792-27 Issued in WI
Practice address
3107 Westhill Dr
Wausau, WI 54401-3774
Phone
(216) 772-1105
NPI assigned
Sep 3, 2021
Last updated
Sep 3, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 5792-27 WI Primary

Addresses

Primary practice location

3107 Westhill Dr
Wausau, WI 54401-3774

Mailing address

1323 Elm St
Almond, WI 54909-9792
Phone (715) 412-4879

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cmoloney@adaptiverehab.com

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
5792-27WIMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1630627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630627200000",
    "number": "1164190161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1323 ELM ST",
            "city": "ALMOND",
            "state": "WI",
            "postal_code": "549099792",
            "telephone_number": "715-412-4879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3107 WESTHILL DR",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544013774",
            "telephone_number": "216-772-1105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLONEY",
        "first_name": "CASSANDRA",
        "middle_name": "LYNN",
        "credential": "OTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-03",
        "last_updated": "2021-09-03",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WI",
            "license": "5792-27",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cmoloney@adaptiverehab.com",
            "affiliation": "N",
            "address_1": "3107 Westhill Dr",
            "city": "Wausau",
            "state": "WI",
            "country_code": "US",
            "postal_code": "544013774",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2021; 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.