Active NPI
Ellen Marie Moran, P.T.
- Physical Therapist
- Mechanicsville, VA
National Provider Identifier
1396949723
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2305205421
- Practice address
- 7090 Covenant Woods Dr
Mechanicsville, VA 23111-7025 - Phone
- (804) 559-8936
- NPI assigned
- Jun 11, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2305205421 | VA | Primary |
Addresses
Primary practice location
7090 Covenant Woods Dr
Mechanicsville, VA 23111-7025
Mailing address
14101 Shawhan PL
Midlothian, VA 23114-3306
Phone (804) 594-7239
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 |
|---|---|---|---|
| 2305205421 | VA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181520000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412640000000",
"number": "1396949723",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14101 SHAWHAN PL",
"city": "MIDLOTHIAN",
"state": "VA",
"postal_code": "231143306",
"telephone_number": "804-594-7239"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7090 COVENANT WOODS DR",
"city": "MECHANICSVILLE",
"state": "VA",
"postal_code": "231117025",
"telephone_number": "804-559-8936"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORAN",
"first_name": "ELLEN",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "P.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-06-11",
"last_updated": "2014-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VA",
"license": "2305205421",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mechanicsville, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.