Pamela Jo Moening, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

103852 Issued in MN

Practice address

1217 Elm St
Northfield, MN 55057-2907

Phone

(612) 597-9143

NPI assigned

Jun 22, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Full Potential Therapy, LLC

  • Occupational Therapist
  • Dundas, MN
  • NPI 1316513427
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1371859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622851200000",
    "number": "1861831844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1217 ELM ST",
            "city": "NORTHFIELD",
            "state": "MN",
            "postal_code": "550572907",
            "telephone_number": "612-597-9143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1217 ELM ST",
            "city": "NORTHFIELD",
            "state": "MN",
            "postal_code": "550572907",
            "telephone_number": "612-597-9143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOENING",
        "first_name": "PAMELA",
        "middle_name": "JO",
        "name_prefix": "Dr.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-22",
        "last_updated": "2021-06-05",
        "certification_date": "2021-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "103852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mind Body Psychotherapy LLC
• Minnesota Odd Fellows Home
• Minnesota Odd Fellows Home
• Minnesota Orthodontics and Dentofacial Orthopedics PA
• Modern Therapeutics PLLC
• Seth Kenton Mogler, DNAP
• Mood and Sleep Clinic
• Alexis Moorhouse, RN
• Kimberly Isis Morris
• Rachel Elizabeth Morrison

• Occupational Therapist in Northfield, MN
• Providers in Northfield, MN by specialty
• Occupational Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.