Jessica M Moule, OTR-L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT12225 Issued in FL

Practice address

11628 SW 50TH CT
Cooper City, FL 33330-4414

Phone

(305) 335-3263

NPI assigned

Nov 24, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Therapy Wonderland LLC

  • Occupational Therapist
  • Cooper City, FL
  • NPI 1154921989
  NPD Authorized official

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346198400000",
    "number": "1871669606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11628 SW 50TH CT",
            "city": "COOPER CITY",
            "state": "FL",
            "postal_code": "333304414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11628 SW 50TH CT",
            "city": "COOPER CITY",
            "state": "FL",
            "postal_code": "333304414",
            "telephone_number": "305-335-3263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOULE",
        "first_name": "JESSICA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "OTR-L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-24",
        "last_updated": "2012-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT12225",
            "primary": true
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "FL",
            "license": "OT12225",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891592000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Cooper City, FL
• Providers in Cooper City, FL by specialty
• Occupational Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2012; 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.