Active NPI
Eric Ryan Moss, OTR/L
- Occupational Therapist
- Bunnell, FL
National Provider Identifier
1255801395
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 17401
- Practice address
- 300 Dr Carter Blvd
Bunnell, FL 32110-6211 - Phone
- (386) 437-4168
- NPI assigned
- Dec 2, 2018
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 17401 | FL | Primary |
Addresses
Primary practice location
300 Dr Carter Blvd
Bunnell, FL 32110-6211
Mailing address
300 Dr Carter Blvd
Bunnell, FL 32110-6211
Phone (386) 437-4168
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 |
|---|---|---|---|
| 17401 | FL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1543708800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1543708800000",
"number": "1255801395",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 DR CARTER BLVD",
"city": "BUNNELL",
"state": "FL",
"postal_code": "321106211",
"telephone_number": "386-437-4168"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 DR CARTER BLVD",
"city": "BUNNELL",
"state": "FL",
"postal_code": "321106211",
"telephone_number": "386-437-4168"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOSS",
"first_name": "ERIC",
"middle_name": "RYAN",
"name_prefix": "Mr.",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-12-02",
"last_updated": "2018-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Occupational Therapist",
"state": "FL",
"license": "17401",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bunnell, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.