Individual provider Active NPI

Angela Moler, PTA

  • Physical Therapy Assistant
  • Knoxville, TN
National Provider Identifier
1639906274
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
8492 Issued in TN
Practice address
10133 Sherrill Blvd Ste 200
Knoxville, TN 37932-3347
Phone
(888) 531-2204
NPI assigned
Sep 17, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 8492 TN Primary

Addresses

Primary practice location

10133 Sherrill Blvd Ste 200
Knoxville, TN 37932-3347

Mailing address

531 Northern Rd
South Daytona, FL 32119-2052
Phone (386) 846-5574

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

LicenseStateTypeSpecialty
8492TNMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1726531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1639906274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "531 NORTHERN RD",
            "city": "SOUTH DAYTONA",
            "state": "FL",
            "postal_code": "321192052",
            "telephone_number": "386-846-5574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10133 SHERRILL BLVD STE 200",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379323347",
            "telephone_number": "888-531-2204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLER",
        "first_name": "ANGELA",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-17",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TN",
            "license": "8492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2024; 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.