Todd L Moutrey, BA, SFA, SA-C

Primary specialty

Surgical AssistantTaxonomy code 246ZC0007X

License

99-197 Issued in CO

Practice address

2424 N. Wyatt Dr.
Tucson, AZ 85712-6118

Phone

(520) 784-6200

Fax

(520) 784-6109

NPI assigned

Jul 31, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Arts

State licenses

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

{
    "created_epoch": "1217462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299715200000",
    "number": "1295991065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31630",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857511630",
            "telephone_number": "520-784-6200",
            "fax_number": "520-784-6109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2424 N. WYATT DR.",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857126118",
            "telephone_number": "520-784-6200",
            "fax_number": "520-784-6109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUTREY",
        "first_name": "TODD",
        "middle_name": "L",
        "credential": "BA, SFA, SA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-31",
        "last_updated": "2011-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "CO",
            "license": "99-197",
            "primary": true
        },
        {
            "code": "246ZS0410X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Technologist",
            "state": "AZ",
            "license": "99-197",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lianne Elizabeth Mourreale, IBCLC
• Sam Moussa
• Sosan L. Moussa, M.D.
• Nika Moussavi, MD
• Abdalla Sayed Abdelrakib Moustafa, M.D.
• Shayda Movahedi
• Move Toward Good
• Medgar Marcial Moya, MD
• Marie A Moyer, RN BSN MA
• Tena Moyer, M.D.

• Surgical Assistant in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Surgical Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2011; 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.