Katelin Nolan Moody

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

6638026 Issued in WI

Practice address

505 Broadway St # 480
Baraboo, WI 53913-2183

Phone

(608) 355-4200

NPI assigned

Oct 7, 2019

Last updated

Oct 7, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1570406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570406400000",
    "number": "1235770579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 ASH ST APT 2",
            "city": "SAUK CITY",
            "state": "WI",
            "postal_code": "535831080",
            "telephone_number": "608-604-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 BROADWAY ST # 480",
            "city": "BARABOO",
            "state": "WI",
            "postal_code": "539132183",
            "telephone_number": "608-355-4200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "425 6th St",
            "address_purpose": "LOCATION",
            "city": "Reedsburg",
            "state": "WI",
            "postal_code": "539591202",
            "country_code": "US",
            "telephone_number": "608-355-4200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOODY",
        "first_name": "KATELIN",
        "middle_name": "NOLAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-07",
        "last_updated": "2019-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "6638026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Baraboo, WI
• Providers in Baraboo, WI by specialty
• Occupational Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2019; 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.