Active NPI
Jay A Moore, MS, OTR/L
- Occupational Therapist
- Raleigh, NC
National Provider Identifier
1801110689
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 3997
- Practice address
- 3001 Spring Forest Rd
Raleigh, NC 27616-2815 - Phone
- (919) 424-8050
- NPI assigned
- Mar 23, 2010
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 3997 | NC | Primary |
Addresses
Primary practice location
3001 Spring Forest Rd
Raleigh, NC 27616-2815
Mailing address
612 Lakeview Ave
Wake Forest, NC 27587-2990
Phone (919) 434-6171
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3997 | NC | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1269302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1269302400000",
"number": "1801110689",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "612 LAKEVIEW AVE",
"city": "WAKE FOREST",
"state": "NC",
"postal_code": "275872990",
"telephone_number": "919-434-6171"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3001 SPRING FOREST RD",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276162815",
"telephone_number": "919-424-8050"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "JAY",
"middle_name": "A",
"credential": "MS, OTR/L",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-03-23",
"last_updated": "2010-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NC",
"license": "3997",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.