Individual provider Active NPI

Linda D Moon, O.T.R.

  • Occupational Therapist
  • Panama City, FL
National Provider Identifier
1659303147
Registry record updated May 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT 10128 Issued in FL
Practice address
7514 Nautical CT
Panama City, FL 32409-4827
Phone
(850) 628-0981
Fax
(850) 786-3638
NPI assigned
Jul 7, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 24, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist 222Q00000X
Low Vision Occupational Therapist 225XL0004X OT 10128 FL
Occupational Therapist 225X00000X OT 10128 FL Primary

Addresses

Primary practice location

7514 Nautical CT
Panama City, FL 32409-4827

Mailing address

7514 Nautical CT
Panama City, FL 32409-4827
Phone (850) 628-0981

Other identifiers 2

IdentifierTypeStateIssuer
116506000MedicaidFL
P00303830OtherFLRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050719000880 FL Practitioner - Occupational Therapist in Private Practice 2365479623 Practice locations: Panama City, FL

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT 10128FLMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716508800000",
    "number": "1659303147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7514 NAUTICAL CT",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324094827",
            "telephone_number": "850-628-0981",
            "fax_number": "850-786-3638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7514 NAUTICAL CT",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324094827",
            "telephone_number": "850-628-0981",
            "fax_number": "850-786-3638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "LINDA",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "O.T.R.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2024-05-24",
        "certification_date": "2024-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XL0004X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Low Vision",
            "state": "FL",
            "license": "OT 10128",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT 10128",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116506000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00303830",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.