Individual provider Active NPI

Thomas Ryan Moss, LOTR

  • Occupational Therapist
  • Bossier City, LA
National Provider Identifier
1780397901
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
333138 Issued in LA
Practice address
1041 Chinaberry Dr Ste 100
Bossier City, LA 71111-2466
Phone
(318) 746-1199
NPI assigned
Jan 3, 2023
Last updated
Oct 23, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 123285 TX
Occupational Therapist 225X00000X 333138 LA Primary

Addresses

Primary practice location

1041 Chinaberry Dr Ste 100
Bossier City, LA 71111-2466

Mailing address

2164 Sweet Bay Cir
Bossier City, LA 71111-6726
Phone (318) 422-0486

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
333138LAMDOccupational Therapist
123285TXMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Therapy Partners LLC PastSince Oct 27, 2024 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1672704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1780397901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2164 SWEET BAY CIR",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711116726",
            "telephone_number": "318-422-0486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1041 CHINABERRY DR STE 100",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711112466",
            "telephone_number": "318-746-1199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSS",
        "first_name": "THOMAS",
        "middle_name": "RYAN",
        "credential": "LOTR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-01-03",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "123285",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "LA",
            "license": "333138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bossier City, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2024; 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.