Individual provider Active NPI

Dory Moon, MPT

  • Physical Therapist
  • Ames, IA
National Provider Identifier
1487624987
Registry record updated Nov 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
02963 Issued in IA
Practice address
3600 Lincoln Way
Ames, IA 50014-7595
Phone
(515) 663-4824
Fax
(515) 663-4860
NPI assigned
Jan 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 02963 IA Primary

Addresses

Primary practice location

3600 Lincoln Way
Ames, IA 50014-7595

Mailing address

205 W Wacker Dr
Suite 1020
Chicago, IL 60606-1216
Phone (312) 640-0329

Other names 1

  • Dory Larson Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dmoon2871@directmcfarlandclinic.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100204000456 IA Practitioner - Physical Therapist in Private Practice 0840333449 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McFarland Clinic PCGroup PAC ID 1254244239, 353 clinicians

Practice addresses (Care Compare)

1215 Duff Ave
Ames, IA 50010-5400
Phone (515) 239-4400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
McFarland Clinic PC CurrentSince Sep 1, 2000 Accepting new patients
Life Enhancing Therapies Physical Therapist Past Accepting new patients

Locations

3600 Lincoln Way
Ames, IA 50014
Phone (515) 239-4492

1215 Duff Ave
Ames, IA 50010
Phone (515) 239-4400

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606176000000",
    "number": "1487624987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 W WACKER DR",
            "address_2": "SUITE 1020",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606061216",
            "telephone_number": "312-640-0329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 LINCOLN WAY",
            "city": "AMES",
            "state": "IA",
            "postal_code": "500147595",
            "telephone_number": "515-663-4824",
            "fax_number": "515-663-4860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "DORY",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-25",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "02963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dmoon2871@directmcfarlandclinic.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "3600 Lincoln Way",
            "city": "Ames",
            "state": "IA",
            "country_code": "US",
            "postal_code": "500147595",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "DORY",
            "last_name": "LARSON",
            "credential": "MPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ames, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.