Individual provider Active NPI

Spandana Moram

  • Physical Therapist
  • Lumberton, NC
National Provider Identifier
1750770095
Registry record updated Jan 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
15371 Issued in NC
Practice address
3709 Deacons Dr
Lumberton, NC 28358-3279
Phone
(402) 304-4733
NPI assigned
Jan 9, 2015
Last updated
Jan 9, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 15371 NC Primary

Addresses

Primary practice location

3709 Deacons Dr
Lumberton, NC 28358-3279

Mailing address

3709 Deacons Rd
Lumberton, NC 28358-3279
Phone (402) 304-4733

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
15371NCMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1420761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420761600000",
    "number": "1750770095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3709 DEACONS RD",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283583279",
            "telephone_number": "402-304-4733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3709 DEACONS DR",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283583279",
            "telephone_number": "402-304-4733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAM",
        "first_name": "SPANDANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-09",
        "last_updated": "2015-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "15371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lumberton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2015; 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.