Individual provider Active NPI

Mary Ellen Taylor, LMT

  • Mechanotherapist
  • Anchorage, AK
National Provider Identifier
1205186129
Registry record updated Feb 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
MechanotherapistTaxonomy code 172M00000X
License
991202 Issued in AK
Practice address
3315 Fairbanks St
Anchorage, AK 99503-4145
Phone
(541) 844-9325
NPI assigned
Sep 18, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mechanotherapist 172M00000X 991202 AK Primary

Addresses

Primary practice location

3315 Fairbanks St
Anchorage, AK 99503-4145

Mailing address

15201 A Snow Flake Dr
Anchorage, AK 99516
Phone (541) 844-9325

Other names 1

  • Miss Mary Ellen Moody Former name

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
991202AKMDMechanotherapist

NPI Registry JSON

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

{
    "created_epoch": "1347926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424822400000",
    "number": "1205186129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15201 A SNOW FLAKE DR",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "99516",
            "telephone_number": "541-844-9325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3315 FAIRBANKS ST",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995034145",
            "telephone_number": "541-844-9325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "MARY",
        "middle_name": "ELLEN",
        "name_prefix": "Ms.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-18",
        "last_updated": "2015-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172M00000X",
            "taxonomy_group": "",
            "desc": "Mechanotherapist",
            "state": "AK",
            "license": "991202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "MOODY",
            "middle_name": "ELLEN",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2015; 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.