Individual provider Active NPI

Deealice Moton, LMT

  • Rehabilitation Practitioner
  • Aiken, SC
National Provider Identifier
1477826071
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
License
9071 Issued in SC
Practice address
6350 Woodside Executive CT
Aiken, SC 29803-3825
Phone
(706) 951-5812
NPI assigned
Feb 14, 2012
Last updated
Jan 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X MAS.9071 SC
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 9071 SC
Interventional Pain Medicine Physician 208VP0014X 9071 SC
Rehabilitation Practitioner 225400000X 9071 SC Primary
Massage Therapist 225700000X MT007357 GA
Military Health Care Provider 171000000X 9071 SC

Addresses

Primary practice location

6350 Woodside Executive CT
Aiken, SC 29803-3825

Mailing address

6240 Woodside Executive CT
Aiken, SC 29803-3822
Phone (706) 627-6005

Other practice location 1

5150 Woodside Executive Ct
Aiken, SC 29803-3814
Phone (706) 627-6005

Other practice location 2

6240 Woodside Executive Ct
Aiken, SC 29803-3822
Phone (803) 226-0089

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250131001916 SC Practitioner - Physical Medicine and RehabilitationPractitioner - Single Or Multispecialty Clinic Or Group Practice 5193166049 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MAS.9071SCMDPhysical Medicine & Rehabilitation Physician
MT007357GAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Deealice Moton HCSR Multi-Specialty CurrentSince Jan 9, 2024 Accepting new patients
Euphoria Naturals Modern Esthetics & Wellness CurrentSince Mar 24, 2024 Accepting new patients
Beaufort Home Health Partners L.L.C. PastSince Jan 12, 2025 Accepting new patients

Locations

5150 Woodside Executive Ct
Aiken, SC 29803
Phone (706) 627-6005

6240 Woodside Executive Ct
Aiken, SC 29803
Phone (706) 627-6005

6350 Woodside Executive Ct
Aiken, SC 29803
Phone (706) 627-6005

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1329177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1477826071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6240 WOODSIDE EXECUTIVE CT",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298033822",
            "telephone_number": "706-627-6005",
            "fax_number": "888-807-5411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6350 WOODSIDE EXECUTIVE CT",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298033825",
            "telephone_number": "706-951-5812"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5150 Woodside Executive Ct",
            "address_purpose": "LOCATION",
            "city": "Aiken",
            "state": "SC",
            "postal_code": "298033814",
            "country_code": "US",
            "telephone_number": "706-627-6005",
            "fax_number": "888-807-5411",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6240 Woodside Executive Ct",
            "address_purpose": "LOCATION",
            "city": "Aiken",
            "state": "SC",
            "postal_code": "298033822",
            "country_code": "US",
            "telephone_number": "803-226-0089",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOTON",
        "first_name": "DEEALICE",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-14",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "SC",
            "license": "MAS.9071",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "SC",
            "license": "9071",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "SC",
            "license": "9071",
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "SC",
            "license": "9071",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "GA",
            "license": "MT007357",
            "primary": false
        },
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": "SC",
            "license": "9071",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aiken, SC

Sources for this page

Verify at the official NPI Registry.