Active NPI
Colleen Una Moody, DSP CRMA
- Adult Companion
- Chelsea, ME
National Provider Identifier
1598092074
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Companion
- License
- ALL53665
- Practice address
- 198 Birmingham Rd
Chelsea, ME 04330 - Phone
- (207) 582-0016
- Fax
- (207) 582-0016
- NPI assigned
- Nov 4, 2009
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Adult Companion | 372600000X | ALL53665 | ME | Primary |
Addresses
Primary practice location
198 Birmingham Rd
Chelsea, ME 04330
Mailing address
198 Birmingham Rd
Chelsea, ME 04330
Phone (207) 582-0016
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 209330000 | Medicaid | ME |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ALL53665 | ME | MD | Adult Companion |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1257292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1257724800000",
"number": "1598092074",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "198 BIRMINGHAM RD",
"city": "CHELSEA",
"state": "ME",
"postal_code": "04330",
"telephone_number": "207-582-0016",
"fax_number": "207-582-0016"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "198 BIRMINGHAM RD",
"city": "CHELSEA",
"state": "ME",
"postal_code": "04330",
"telephone_number": "207-582-0016",
"fax_number": "207-582-0016"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOODY",
"first_name": "COLLEEN",
"middle_name": "UNA",
"credential": "DSP CRMA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-11-04",
"last_updated": "2009-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "372600000X",
"taxonomy_group": "",
"desc": "Adult Companion",
"state": "ME",
"license": "ALL53665",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "209330000",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chelsea, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.