NPIMap

Organization Active NPI

Moody Street Total Health, Inc.

  • Chiropractor
  • Waltham, MA
National Provider Identifier
1447237185
Registry record updated Jul 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2269 Issued in MA
Legal business name
MOODY STREET TOTAL HEALTH, INC.
Practice address
3 Common Street #2
Waltham, MA 02451
Phone
(978) 821-7054
Fax
(774) 208-0712
NPI assigned
Dec 23, 2005
Last updated
Jul 21, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2021

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

Authorized official

Name
Karen Lynn St.LaurentNPI 1780660712
Title
Owner
Phone
(978) 821-7054

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 2269 MA Primary

Addresses

Primary practice location

3 Common Street #2
Waltham, MA 02451

Mailing address

3 Common Street #2
Waltham, MA 02451
Phone (978) 821-7054

National Provider Directory

National Provider Directory

Locations

3 Common St
#2
Waltham, MA 02451
Phone (978) 821-7054

515 Moody St
Waltham, MA 02453
Phone (781) 647-5550

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1135296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626825600000",
    "number": "1447237185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 COMMON STREET #2",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "02451",
            "telephone_number": "978-821-7054",
            "fax_number": "774-208-0712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 COMMON STREET #2",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "02451",
            "telephone_number": "978-821-7054",
            "fax_number": "774-208-0712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOODY STREET TOTAL HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-23",
        "last_updated": "2021-07-21",
        "certification_date": "2021-06-24",
        "status": "A",
        "authorized_official_last_name": "ST.LAURENT",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "978-821-7054"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "2269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waltham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2021; 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.