Individual provider Active NPI

Jay Forrest Mosesson, PT, DPT, CERT. MDT

  • Physical Therapist
  • Chapel Hill, NC
National Provider Identifier
1386663698
Registry record updated Jul 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT11595 Issued in NC
Practice address
1717 Legion Rd
Ste 102
Chapel Hill, NC 27517-2396
Phone
(919) 360-6038
Fax
(919) 590-1958
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT16003 CA
Physical Therapist 225100000X PT11595 NC Primary

Addresses

Primary practice location

1717 Legion Rd
Ste 102
Chapel Hill, NC 27517-2396

Mailing address

368 Legend Oaks Dr
Chapel Hill, NC 27517-6122
Phone (919) 360-6038

Other identifiers 2

IdentifierTypeStateIssuer
P11595OtherNCNC PT LICENCE
PT16003OtherCACA PT LICENCE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141201000940 NC Practitioner - Physical Therapist in Private Practice 8426032665 Practice locations: Chapel Hill, NC; Raleigh, NC

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1717 Legion Rd
Suite 102
Chapel Hill, NC 27517-2396
Phone (919) 360-6038

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16003CAMDClinical Social Worker
PT16003CAMDPhysical Therapist
PT11595NCMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690156800000",
    "number": "1386663698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "368 LEGEND OAKS DR",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275176122",
            "telephone_number": "919-360-6038",
            "fax_number": "919-590-1958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 LEGION RD",
            "address_2": "STE 102",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275172396",
            "telephone_number": "919-360-6038",
            "fax_number": "919-590-1958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSESSON",
        "first_name": "JAY",
        "middle_name": "FORREST",
        "name_prefix": "Dr.",
        "credential": "PT, DPT,  CERT. MDT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT16003",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "PT11595",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC PT  LICENCE",
            "identifier": "P11595",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA PT LICENCE",
            "identifier": "PT16003",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chapel Hill, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.