Active NPI
Kimberly A Moran, OCCUPATIONAL THERAPY
- Occupational Therapist
- Agawam, MA
National Provider Identifier
1164542569
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 3710
- Practice address
- 65 Cooper St
Agawam, MA 01001-2149 - Phone
- (413) 786-8000
- NPI assigned
- Mar 30, 2007
- 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 | 3710 | MA | Primary |
Addresses
Primary practice location
65 Cooper St
Agawam, MA 01001-2149
Mailing address
16 North LN
Hadley, MA 01035-3525
Phone (413) 586-8809
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Care Compare profile
Medicare Care Compare- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 1992
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
194 Peach St
Westfield, MA 01085-5157
PO Box
821322 Attn Powerback Credentialing Dept
Philadelphia, PA 19182-1322
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1164542569",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16 NORTH LN",
"city": "HADLEY",
"state": "MA",
"postal_code": "010353525",
"telephone_number": "413-586-8809"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "65 COOPER ST",
"city": "AGAWAM",
"state": "MA",
"postal_code": "010012149",
"telephone_number": "413-786-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORAN",
"first_name": "KIMBERLY",
"middle_name": "A",
"credential": "OCCUPATIONAL THERAPY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MA",
"license": "3710",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Agawam, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- 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.