Jordan Mooney, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

1735 Issued in ND

Practice address

7151 15TH St S
Fargo, ND 58104-6613

Phone

(701) 364-2950

NPI assigned

Oct 14, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2019

Medicare assignment

May accept Medicare assignment

Group practices

Valley Christian Counseling Center IncGroup PAC ID 6709845654, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Valley Christian Counseling Center Inc

  • Professional Counselor
  • Fargo, ND
  • NPI 1467559427

  Occupational Therapist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1571011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571011200000",
    "number": "1497397111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5007",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587025007",
            "telephone_number": "701-852-3628",
            "fax_number": "701-852-1190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7151 15TH ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581046613",
            "telephone_number": "701-364-2950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOONEY",
        "first_name": "JORDAN",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-14",
        "last_updated": "2019-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ND",
            "license": "1735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dfs@dakotaranch.org",
            "affiliation": "N",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "7151 15th St S",
            "city": "Fargo",
            "state": "ND",
            "country_code": "US",
            "postal_code": "581046613",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Robert C Montgomery, MD
• Roberta J Montgomery, CNP
• Sean Montgomery, MD
• Tinika A Montgomery, M.D.
• Kimberly Ann Moon
• Michelle Renae Moore, LPN
• Tracy B Moore
• Wendy M Moore, NURSE PRACTITIONER
• Whitney Moore
• Kaylee Anne Moorehouse, RN

• Occupational Therapist in Fargo, ND
• Providers in Fargo, ND by specialty
• Occupational Therapist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2019; 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.