Individual provider Active NPI

Kevin Moul, BS, CRSW

  • Peer Specialist
  • Manchester, NH
National Provider Identifier
1649828617
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
License
0144 Issued in NH
Practice address
2 Wall St Ste 300
Manchester, NH 03101-1518
Phone
(603) 668-4111
NPI assigned
Sep 3, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X 0144 NH Primary

Addresses

Primary practice location

2 Wall St Ste 300
Manchester, NH 03101-1518

Mailing address

2 Wall St Ste 300
Manchester, NH 03101-1518
Phone (603) 668-4111

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address TheMentalHealthCenterofGreaterManchester@mhcgm.netsmartdirect.net Health Information Exchange (HIE)

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
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
0144NHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Mental Health Center of Greater Manchester PastSince Sep 8, 2019 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1567468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1649828617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 WALL ST STE 300",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031011518",
            "telephone_number": "603-668-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 WALL ST STE 300",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031011518",
            "telephone_number": "603-668-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUL",
        "first_name": "KEVIN",
        "credential": "BS, CRSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-03",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "NH",
            "license": "0144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "TheMentalHealthCenterofGreaterManchester@mhcgm.netsmartdirect.net",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2 Wall St Ste 300",
            "city": "Manchester",
            "state": "NH",
            "country_code": "US",
            "postal_code": "031011518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2021; 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.