Individual provider Active NPI

Dana E Moulton, OTR/L, CHT

  • Hand Occupational Therapist
  • Bradenton, FL
National Provider Identifier
1801894613
Registry record updated Dec 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
License
15765 Issued in FL
Practice address
6015 Pointe West Blvd
Bradenton, FL 34209
Phone
(941) 591-0207
Fax
(941) 761-0712
NPI assigned
Jul 14, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hand Occupational Therapist 225XH1200X 15765 FL Primary

Addresses

Primary practice location

6015 Pointe West Blvd
Bradenton, FL 34209

Mailing address

6015 Pointe West Blvd
Bradenton, FL 34209-5525
Phone (941) 591-0207

Other identifiers 1

IdentifierTypeStateIssuer
4BBN1OtherFLFL BCBS

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
15765FLMDHand Occupational Therapist
5962SCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rehabclinics SPT Inc Past Accepting new patients
Shoals Orthopedics, PC Past Accepting new patients
Physical Rehabilitation Group PastSince Dec 28, 2020 Accepting new patients
Gulf Breeze Physical Therapy Inc. Past Accepting new patients

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543881600000",
    "number": "1801894613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6015 POINTE WEST BLVD",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342095525",
            "telephone_number": "941-591-0207",
            "fax_number": "941-761-0712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6015 POINTE WEST BLVD",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "34209",
            "telephone_number": "941-591-0207",
            "fax_number": "941-761-0712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOULTON",
        "first_name": "DANA",
        "middle_name": "E",
        "credential": "OTR/L, CHT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-14",
        "last_updated": "2018-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "FL",
            "license": "15765",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL BCBS",
            "identifier": "4BBN1",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2018; 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.