Active NPI
Joanna K. Moynihan, DPT
- Physical Therapist
- Danvers, MA
National Provider Identifier
1730479395
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 18930
- Practice address
- 156 Andover St Unit 2
Danvers, MA 01923-1468 - Phone
- (978) 767-8343
- Fax
- (978) 767-8349
- NPI assigned
- Apr 15, 2011
- Sex
- Female
- 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 | 18930 | MA | Primary |
Addresses
Primary practice location
156 Andover St Unit 2
Danvers, MA 01923-1468
Mailing address
1 Credit Union Way FL 3
Randolph, MA 02368-4633
Phone (781) 961-3370
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9604746 | Other | MA | AETNA |
| 1227803 | Other | MA | ASH/CIGNA |
| 110089945A | Medicaid | MA | |
| 051773 | Other | MA | OPTUM/UHC |
Other names 1
- Joanna Kagan
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1302825600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1540512000000",
"number": "1730479395",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 CREDIT UNION WAY FL 3",
"city": "RANDOLPH",
"state": "MA",
"postal_code": "023684633",
"telephone_number": "781-961-3370",
"fax_number": "781-767-7531"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "156 ANDOVER ST UNIT 2",
"city": "DANVERS",
"state": "MA",
"postal_code": "019231468",
"telephone_number": "978-767-8343",
"fax_number": "978-767-8349"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOYNIHAN",
"first_name": "JOANNA",
"middle_name": "K.",
"name_prefix": "Mrs.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-04-15",
"last_updated": "2018-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MA",
"license": "18930",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "9604746",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ASH/CIGNA",
"identifier": "1227803",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110089945A",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OPTUM/UHC",
"identifier": "051773",
"state": "MA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JOANNA",
"last_name": "KAGAN",
"credential": "DPT",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Danvers, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.