Active NPI
Kristin Carolyne Moser, PT
- Physical Therapist
- Simpsonville, SC
National Provider Identifier
1336403666
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 7066
- Practice address
- 727 SE Main St
Ste 200
Simpsonville, SC 29681-3247 - Phone
- (864) 454-6670
- NPI assigned
- Jul 2, 2012
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 7066 | SC | Primary |
| Physical Therapist | 225100000X | 004797 | IA |
Addresses
Primary practice location
727 SE Main St
Ste 200
Simpsonville, SC 29681-3247
Mailing address
790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2223
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 |
|---|---|---|---|
| 004797 | IA | MD | Physical Therapist |
| 7066 | SC | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prisma Health University Medical Group | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Family Medicine Physician
- Greenville, SC
- NPI 1295763217
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1341187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458518400000",
"number": "1336403666",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "790 REMINGTON BLVD",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604404909",
"telephone_number": "630-296-2223"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "727 SE MAIN ST",
"address_2": "STE 200",
"city": "SIMPSONVILLE",
"state": "SC",
"postal_code": "296813247",
"telephone_number": "864-454-6670"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOSER",
"first_name": "KRISTIN",
"middle_name": "CAROLYNE",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-02",
"last_updated": "2016-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "SC",
"license": "7066",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IA",
"license": "004797",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Simpsonville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.