Active NPI
Moya Kinnealey, O.T.
- Occupational Therapist
- Philadelphia, PA
National Provider Identifier
1760652754
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OC000705L
- Practice address
- 4212 Chestnut St
2ND Floor
Philadelphia, PA 19104-3015 - Phone
- (215) 382-3171
- NPI assigned
- Mar 5, 2008
- Sex
- Female
- 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 | OC000705L | PA | Primary |
Addresses
Primary practice location
4212 Chestnut St
2ND Floor
Philadelphia, PA 19104-3015
Mailing address
4212 Chestnut St
2ND Floor
Philadelphia, PA 19104-3015
Phone (215) 382-3171
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0019370400004 | Other | PA | PROVIDER NUMBER |
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 |
|---|---|---|---|
| OC000705L | PA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1204675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204675200000",
"number": "1760652754",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4212 CHESTNUT ST",
"address_2": "2ND FLOOR",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191043015",
"telephone_number": "215-382-3171"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4212 CHESTNUT ST",
"address_2": "2ND FLOOR",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191043015",
"telephone_number": "215-382-3171"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KINNEALEY",
"first_name": "MOYA",
"credential": "O.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-03-05",
"last_updated": "2008-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "PA",
"license": "OC000705L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PROVIDER NUMBER",
"identifier": "0019370400004",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.