Individual provider Active NPI

Stacy L Moses, OTR/L

  • Occupational Therapist
  • London, KY
National Provider Identifier
1851556955
Registry record updated Apr 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
131820 Issued in KY
Practice address
100 Mountain View Drive
London, KY 40741
Phone
(606) 330-0513
NPI assigned
Jul 28, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Rehabilitation Occupational Therapist 225XP0019X R3386 KY
Occupational Therapist 225X00000X 131820 KY Primary

Addresses

Primary practice location

100 Mountain View Drive
London, KY 40741

Mailing address

100 Mountain View Drive
London, KY 40741
Phone (606) 330-0513

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140930001659 KY Practitioner - Occupational Therapist in Private Practice 4688894439 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PT Solutions Holdings LLCGroup PAC ID 0749235471, 7 clinicians

Practice addresses (Care Compare)

2344 Elkhorn Rd
Suite 150
Lexington, KY 40509-2786
Phone (859) 788-2369

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
131820KYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Joseph Health System, Inc. PastSince Jul 23, 2014 Accepting new patients
PT Solutions Holdings, LLC PastSince Jan 23, 2023 Accepting new patients

Organizations & group practices 3

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": "1217203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524787200000",
    "number": "1851556955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MOUNTAIN VIEW DRIVE",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "40741",
            "telephone_number": "606-330-0513",
            "fax_number": "606-330-0516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MOUNTAIN VIEW DRIVE",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "40741",
            "telephone_number": "606-330-0513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSES",
        "first_name": "STACY",
        "middle_name": "L",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-28",
        "last_updated": "2018-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "KY",
            "license": "R3386",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "KY",
            "license": "131820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in London, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.