Pamela Marie Moore, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT003205 Issued in GA

Practice address

6595 Cole Rd
Hahira, GA 31632-3621

Phone

(229) 563-0811

Fax

(229) 794-8009

NPI assigned

Sep 1, 2005

Last updated

Oct 15, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Sensational Kids Therapy Services, LLC

  • Occupational Therapist
  • Hahira, GA
  • NPI 1356452882
  NPD (past)

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

{
    "created_epoch": "1125532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350259200000",
    "number": "1477547701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6595 COLE RD",
            "city": "HAHIRA",
            "state": "GA",
            "postal_code": "316323621",
            "telephone_number": "229-563-0811",
            "fax_number": "229-794-8009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6595 COLE RD",
            "city": "HAHIRA",
            "state": "GA",
            "postal_code": "316323621",
            "telephone_number": "229-563-0811",
            "fax_number": "229-794-8009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "PAMELA",
        "middle_name": "MARIE",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-01",
        "last_updated": "2012-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT003205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000885849E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lynn Kathryn Luria, MSW
• Lyndi N Farnam, LLC
• Lequinnaka L Mims, CPHT
• Kristina Rae Molina-Croes
• Michayla H Moody, MS CCC-SLP
• Britney Heather Nash, PHARMD
• Pamela Michelle Nisen, ADVANCED PRACTICE NP
• One Lucky Seven Corporation
• Orchard Hospice, Inc. (Orchard Hospice)
• Alyssa Pate, PHARM.D.

• Occupational Therapist in Hahira, GA
• Providers in Hahira, GA by specialty
• Occupational Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2012; 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.