Active NPI
Robert Mooney, P.T.
- Pediatric Physical Therapist
- Woodland, CA
National Provider Identifier
1790858256
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- PT22218
- Practice address
- 285 W Beamer St
Room a
Woodland, CA 95695-2510 - Phone
- (530) 666-6184
- Fax
- (530) 666-6155
- NPI assigned
- Nov 15, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | PT22218 | CA | Primary |
Addresses
Primary practice location
285 W Beamer St
Room a
Woodland, CA 95695-2510
Mailing address
3791 Moddison Ave
Sacramento, CA 95819-1523
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 |
|---|---|---|---|
| PT22218 | CA | MD | Pediatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1790858256",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3791 MODDISON AVE",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958191523"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "285 W BEAMER ST",
"address_2": "ROOM A",
"city": "WOODLAND",
"state": "CA",
"postal_code": "956952510",
"telephone_number": "530-666-6184",
"fax_number": "530-666-6155"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOONEY",
"first_name": "ROBERT",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "CA",
"license": "PT22218",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.