Active NPI
Thomas James Moodie, OTR
- Occupational Therapist
- Hillsboro, WI
National Provider Identifier
1295355741
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 6766-26
- Practice address
- 400 Water Ave
Hillsboro, WI 54634-9054 - Phone
- (608) 489-8000
- NPI assigned
- Apr 24, 2020
- Last updated
- Apr 24, 2020
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 6766-26 | WI | Primary |
Addresses
Primary practice location
400 Water Ave
Hillsboro, WI 54634-9054
Mailing address
855 Panorama CT Apt 313
Richland Center, WI 53581-9217
Phone (608) 335-9733
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6766-26 | Other | WI | WISCONSIN DSPS OCCUPATIONAL THERAPY LICENSE |
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 |
|---|---|---|---|
| 6766-26 | WI | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1587686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1587686400000",
"number": "1295355741",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "855 PANORAMA CT APT 313",
"city": "RICHLAND CENTER",
"state": "WI",
"postal_code": "535819217",
"telephone_number": "608-335-9733"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 WATER AVE",
"city": "HILLSBORO",
"state": "WI",
"postal_code": "546349054",
"telephone_number": "608-489-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOODIE",
"first_name": "THOMAS",
"middle_name": "JAMES",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-04-24",
"last_updated": "2020-04-24",
"certification_date": "2020-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WI",
"license": "6766-26",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WISCONSIN DSPS OCCUPATIONAL THERAPY LICENSE",
"identifier": "6766-26",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hillsboro, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 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.