Jessica Lynn Moon, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT02043 Issued in RI

Practice address

593 Eddy St
Providence, RI 02903-4923

Phone

(401) 444-5020

NPI assigned

Jan 22, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Excella Healthcare, Inc.

  dba Encompass Home Health of New England

  • Physical Therapist
  • Andover, MA
  • NPI 1033177720
  NPD (past)

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1598819237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "354 FRANKLIN ST",
            "city": "MANSFIELD",
            "state": "MA",
            "postal_code": "020481659",
            "telephone_number": "508-339-8875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-5020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "RI",
            "license": "PT02043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Montross, MD
• Mikhaela Monty, M.D.
• Carmen V Monzon, MD
• Matthew Mooers, PSYD
• Remo Moomiaie, M.D.
• Sydney Sumi Moon, M.D.
• Jacob Mooney
• Moonstone Mothering Perinatal Services LLC
• Pamela Susan Moorby, RN
• Ashley Moore, M.A.,C.A.G.S.,C.R.C.

• Physical Therapist in Providence, RI
• Providers in Providence, RI by specialty
• Physical Therapist in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.