Active NPI
Skyler Mahlon Moxley, OTR
- Occupational Therapist
- St. Joseph, MO
National Provider Identifier
1487236386
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 2021010842
- Practice address
- 3310 N. Woodbine Rd.
St. Joseph, MO 64505 - Phone
- (816) 720-7459
- NPI assigned
- Apr 21, 2021
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 2021010842 | MO | Primary |
Addresses
Primary practice location
3310 N. Woodbine Rd.
St. Joseph, MO 64505
Mailing address
141 Cardinal Cir
Lawson, MO 64062
Phone (816) 807-9470
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2021010842 | MO | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618963200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618963200000",
"number": "1487236386",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "141 CARDINAL CIR",
"city": "LAWSON",
"state": "MO",
"postal_code": "64062",
"telephone_number": "816-807-9470"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3310 N. WOODBINE RD.",
"city": "ST. JOSEPH",
"state": "MO",
"postal_code": "64505",
"telephone_number": "816-720-7459"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOXLEY",
"first_name": "SKYLER",
"middle_name": "MAHLON",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-04-21",
"last_updated": "2021-04-21",
"certification_date": "2021-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MO",
"license": "2021010842",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St. Joseph, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 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.