Active NPI
Mara Moffie, A.T.C., NASM-PES
- Athletic Trainer
- Brookline, MA
National Provider Identifier
1225065840
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 1397
- Practice address
- 20 Newton St
Brookline, MA 02445-7407 - Phone
- (617) 454-2787
- NPI assigned
- Jun 27, 2006
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 1397 | MA | Primary |
Addresses
Primary practice location
20 Newton St
Brookline, MA 02445-7407
Mailing address
20 Newton St.
Brookline, MA 02445-3702
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1397 | MA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1238544000000",
"number": "1225065840",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 NEWTON ST.",
"city": "BROOKLINE",
"state": "MA",
"postal_code": "024453702"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 NEWTON ST",
"city": "BROOKLINE",
"state": "MA",
"postal_code": "024457407",
"telephone_number": "617-454-2787"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOFFIE",
"first_name": "MARA",
"credential": "A.T.C., NASM-PES",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-27",
"last_updated": "2009-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MA",
"license": "1397",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brookline, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.