Active NPI
Bradley Don Moulden, OTR/L
- Occupational Therapist
- Louisville, KY
National Provider Identifier
1659043271
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 132380
- Practice address
- 8203 Thornwood Rd
Louisville, KY 40220-2887 - Phone
- (502) 552-6648
- NPI assigned
- Oct 1, 2021
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 132380 | KY | Primary |
Addresses
Primary practice location
8203 Thornwood Rd
Louisville, KY 40220-2887
Mailing address
8203 Thornwood Rd
Louisville, KY 40220-2887
Phone (502) 552-6648
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 132380 | Other | KY | OCCUPATIONAL THERAPIST LICENSE |
| 31001444A | Other | IN | OCCUPATIONAL THERAPIST LICENSE |
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 |
|---|---|---|---|
| 132380 | KY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1633046400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1633046400000",
"number": "1659043271",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8203 THORNWOOD RD",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402202887",
"telephone_number": "502-552-6648"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8203 THORNWOOD RD",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402202887",
"telephone_number": "502-552-6648"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOULDEN",
"first_name": "BRADLEY",
"middle_name": "DON",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-10-01",
"last_updated": "2021-10-01",
"certification_date": "2021-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "KY",
"license": "132380",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OCCUPATIONAL THERAPIST LICENSE",
"identifier": "132380",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OCCUPATIONAL THERAPIST LICENSE",
"identifier": "31001444A",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.