Active NPI
Kelly Dorr Moates, LMFT
- Marriage & Family Therapist
- Decatur, AL
National Provider Identifier
1235327248
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- L267
- Practice address
- 224 2ND Ave SE
Decatur, AL 35601-2344 - Phone
- (256) 341-0811
- Fax
- (256) 341-9358
- NPI assigned
- Oct 4, 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | L267 | AL | Primary |
Addresses
Primary practice location
224 2ND Ave SE
Decatur, AL 35601-2344
Mailing address
224 2ND Ave SE
Decatur, AL 35601-2344
Phone (256) 341-0811
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 51541679 | Other | AL | FEDERAL BCBS |
| 51528347 | Other | AL | BCBS OF AL |
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 |
|---|---|---|---|
| L267 | AL | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1191456000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191456000000",
"number": "1235327248",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "224 2ND AVE SE",
"city": "DECATUR",
"state": "AL",
"postal_code": "356012344",
"telephone_number": "256-341-0811",
"fax_number": "256-341-9358"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "224 2ND AVE SE",
"city": "DECATUR",
"state": "AL",
"postal_code": "356012344",
"telephone_number": "256-341-0811",
"fax_number": "256-341-9358"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOATES",
"first_name": "KELLY",
"middle_name": "DORR",
"credential": "LMFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-10-04",
"last_updated": "2007-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "AL",
"license": "L267",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FEDERAL BCBS",
"identifier": "51541679",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF AL",
"identifier": "51528347",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Decatur, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.