Active NPI
Michael Scott Moffit, CTRS
- Recreation Therapist
- Kalamazoo, MI
National Provider Identifier
1447492160
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Recreation Therapist
- License
- 53006
- Practice address
- 5988 Venture Park Dr
Kalamazoo, MI 49009-2825 - Phone
- (269) 492-7205
- Fax
- (269) 492-7204
- NPI assigned
- Mar 26, 2009
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Recreation Therapist | 225800000X | 53006 | MI | Primary |
Addresses
Primary practice location
5988 Venture Park Dr
Kalamazoo, MI 49009-2825
Mailing address
5988 Venture Park Dr
Kalamazoo, MI 49009-2825
Phone (269) 492-7205
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 |
|---|---|---|---|
| 53006 | MI | MD | Recreation Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1238025600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1238025600000",
"number": "1447492160",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5988 VENTURE PARK DR",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "490092825",
"telephone_number": "269-492-7205",
"fax_number": "269-492-7204"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5988 VENTURE PARK DR",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "490092825",
"telephone_number": "269-492-7205",
"fax_number": "269-492-7204"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOFFIT",
"first_name": "MICHAEL",
"middle_name": "SCOTT",
"name_prefix": "Mr.",
"credential": "CTRS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-03-26",
"last_updated": "2009-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "225800000X",
"taxonomy_group": "",
"desc": "Recreation Therapist",
"state": "MI",
"license": "53006",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kalamazoo, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.