NPIMap

Organization Active NPI

Janet Moulton, Inc.

Doing business as Pediatric Therapy Associates

  • Physical Therapy Clinic/Center
  • Yulee, FL
National Provider Identifier
1225654908
Registry record updated Jun 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
JANET MOULTON, INC.
Doing business as
Pediatric Therapy Associates
Practice address
463380 State Road 200 Unit a
Yulee, FL 32097-3240
Phone
(904) 249-8893
Fax
(904) 372-0496
NPI assigned
Jun 18, 2020
Last updated
Jun 18, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2020

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

Authorized official

Name
Charlotte Lavergne
Title
Billing Agent
Phone
(904) 879-4230

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

463380 State Road 200 Unit a
Yulee, FL 32097-3240

Mailing address

340 16TH Ave N Ste B
Jacksonville Beach, FL 32250-4819
Phone (904) 249-8893

Other names 1

  • Pediatric Therapy Associates Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Janet Moulton Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1592438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592438400000",
    "number": "1225654908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 16TH AVE N STE B",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322504819",
            "telephone_number": "904-249-8893",
            "fax_number": "904-372-0496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "463380 STATE ROAD 200 UNIT A",
            "city": "YULEE",
            "state": "FL",
            "postal_code": "320973240",
            "telephone_number": "904-249-8893",
            "fax_number": "904-372-0496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JANET MOULTON, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-18",
        "last_updated": "2020-06-18",
        "certification_date": "2020-06-18",
        "status": "A",
        "authorized_official_last_name": "LAVERGNE",
        "authorized_official_first_name": "CHARLOTTE",
        "authorized_official_title_or_position": "BILLING AGENT",
        "authorized_official_telephone_number": "904-879-4230"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pediatric Therapy Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Yulee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2020; 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.