Active NPI
Martin James Moran, PT, DPT
- Physical Therapist
- Wpafb, OH
National Provider Identifier
1609656453
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT6632
- Practice address
- 4881 Sugar Maple Dr
Wpafb, OH 45433-5529 - Phone
- (205) 568-2204
- NPI assigned
- Sep 29, 2023
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT6632 | ME | Primary |
Addresses
Primary practice location
4881 Sugar Maple Dr
Wpafb, OH 45433-5529
Mailing address
4881 Sugar Maple Dr
Wright Patterson Afb, OH 45433-5529
Phone (205) 568-2204
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 |
|---|---|---|---|
| PT6632 | ME | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1695945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698710400000",
"number": "1609656453",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4881 SUGAR MAPLE DR",
"city": "WRIGHT PATTERSON AFB",
"state": "OH",
"postal_code": "454335529",
"telephone_number": "205-568-2204"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4881 SUGAR MAPLE DR",
"city": "WPAFB",
"state": "OH",
"postal_code": "454335529",
"telephone_number": "205-568-2204"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORAN",
"first_name": "MARTIN",
"middle_name": "JAMES",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-09-29",
"last_updated": "2023-10-31",
"certification_date": "2023-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ME",
"license": "PT6632",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wpafb, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.