Active NPI
Teckla P Moulton, P.T.
- Physical Therapist
- North Andover, MA
National Provider Identifier
1215070677
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2668
- Practice address
- 231 Sutton St
Suite 1C
North Andover, MA 01845-1620 - Phone
- (978) 685-8059
- Fax
- (978) 685-6421
- NPI assigned
- Feb 15, 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2668 | MA | Primary |
Addresses
Primary practice location
231 Sutton St
Suite 1C
North Andover, MA 01845-1620
Mailing address
231 Sutton St
Suite 1C
North Andover, MA 01845-1620
Phone (978) 685-8059
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0397903 | Medicaid | MA | |
| MOY65938 | Other | MA | BLUE CROSS |
Other names 1
- Miss Teckla Persons
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2668 | MA | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Therafit-Tewksbury, Inc. | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Therapist
- Tewksbury, MA
- NPI 1851434013
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1198195200000",
"number": "1215070677",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "231 SUTTON ST",
"address_2": "SUITE 1C",
"city": "NORTH ANDOVER",
"state": "MA",
"postal_code": "018451620",
"telephone_number": "978-685-8059",
"fax_number": "978-685-6421"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "231 SUTTON ST",
"address_2": "SUITE 1C",
"city": "NORTH ANDOVER",
"state": "MA",
"postal_code": "018451620",
"telephone_number": "978-685-8059",
"fax_number": "978-685-6421"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOULTON",
"first_name": "TECKLA",
"middle_name": "P",
"name_prefix": "Mrs.",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-15",
"last_updated": "2007-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MA",
"license": "2668",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0397903",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "MOY65938",
"state": "MA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "TECKLA",
"last_name": "PERSONS",
"prefix": "MISS",
"credential": "P.T.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in North Andover, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.