Individual provider Active NPI

Marci Moffitt, PT

  • Physical Therapist
  • Jonesboro, AR
National Provider Identifier
1174090625
Registry record updated Jan 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT4064 Issued in AR
Practice address
1500 S Caraway Rd Ste B
Jonesboro, AR 72401-5308
Phone
(870) 530-9007
Fax
(870) 698-8059
NPI assigned
Nov 1, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2025

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 PT4064 AR Primary

Addresses

Primary practice location

1500 S Caraway Rd Ste B
Jonesboro, AR 72401-5308

Mailing address

260 E Chestnut St
Batesville, AR 72501-4530
Phone (870) 307-8863

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250114002038 AR Practitioner - Physical Therapist in Private Practice 0143758482 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vital Movement LLCGroup PAC ID 9335677673, 2 clinicians

Practice addresses (Care Compare)

1500 B S Caraway Rd
Jonesboro, AR 72401-5308
Phone (870) 636-9202

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Vital Movement, LLC Physical Therapist CurrentSince Jan 1, 2025 Accepting new patients
Jonesboro Wellness LLC PastSince Jun 28, 2020 Accepting new patients

Locations

1500 S Caraway Rd
#B
Jonesboro, AR 72401
Phone (870) 530-9007

1500B S Caraway Rd
Jonesboro, AR 72401
Phone (870) 636-9202

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1541030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737244800000",
    "number": "1174090625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 E CHESTNUT ST",
            "city": "BATESVILLE",
            "state": "AR",
            "postal_code": "725014530",
            "telephone_number": "870-307-8863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 S CARAWAY RD STE B",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724015308",
            "telephone_number": "870-530-9007",
            "fax_number": "870-698-8059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOFFITT",
        "first_name": "MARCI",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-01",
        "last_updated": "2025-01-19",
        "certification_date": "2025-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "PT4064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.