Moktar Masanamo Batibure, MOT

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

CG61006256 Issued in WA

Practice address

2102 E Sprague Ave
Spokane, WA 99202-3125

Phone

(509) 838-4651

Fax

(509) 363-2762

NPI assigned

Dec 5, 2017

Sex

Male

Sole proprietor

Yes

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

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Frontier Behavioral Health

  • Community/Behavioral Health Agency
  • Spokane, WA
  • NPI 1861495327
  NPD

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

{
    "created_epoch": "1512432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574294400000",
    "number": "1437664034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 S DIVISION ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992021510",
            "telephone_number": "509-838-4651",
            "fax_number": "509-363-2762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2102 E SPRAGUE AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992023125",
            "telephone_number": "509-838-4651",
            "fax_number": "509-363-2762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BATIBURE",
        "first_name": "MOKTAR",
        "middle_name": "MASANAMO",
        "credential": "MOT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-12-05",
        "last_updated": "2019-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WA",
            "license": "CG61006256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heidi Denise Bates, RN
• Jacqueline Bates, CRNA
• James Tyler Bates, DO
• Leora Marlene Bates, MSW
• Steven Brady Bates, DDS
• Patricia Ann Batie, LMP
• Braden William Batkoff, MD, FACC
• Rhiann Batson
• Clark Dana Battan, OTR/L
• Janis E Battan, OTR/L

• Student in an Organized Health Care Education/Training Program in Spokane, WA
• Providers in Spokane, WA by specialty
• Student in an Organized Health Care Education/Training Program in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2019; 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.