Pamela Marie Moore, OTR
Individual provider Active NPI Occupational Therapist · Hahira, GA
NPI 1477547701 · NPPES record last updated Oct 15, 2012
Key facts
- NPI
- 1477547701
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- OT003205 (GA)
- Practice address
- 6595 Cole Rd
Hahira, GA 31632-3621 - Phone
- (229) 563-0811
- Fax
- (229) 794-8009
- NPI assigned
- Sep 1, 2005
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT003205 | GA | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sensational Kids Therapy Services, LLC | Occupational Therapist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT003205 | GA | Yes |
Addresses
Primary practice location
6595 Cole Rd
Hahira, GA 31632-3621
Mailing address
6595 Cole Rd
Hahira, GA 31632-3621
Phone (229) 563-0811
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000885849E | Medicaid | GA |
Other providers in Hahira, GA
- Lynn Kathryn Luria
- Lyndi N Farnam, LLC
- Lequinnaka L Mims
- Kristina Rae Molina-Croes
- Michayla H Moody
- Britney Heather Nash
- Pamela Michelle Nisen
- Orchard Hospice, Inc.
- Alyssa Pate
- Sarah Merree Peek
All providers in Hahira, GA · Occupational Therapist in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 15, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.