Active NPI
Michaela Moody
- Physical Therapy Assistant
- Hagerstown, MD
National Provider Identifier
1902559586
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- A5619
- Practice address
- 1045 Maryland Ave
Hagerstown, MD 21740-7201 - Phone
- (301) 739-5437
- NPI assigned
- Feb 2, 2022
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | A5619 | MD | Primary |
Addresses
Primary practice location
1045 Maryland Ave
Hagerstown, MD 21740-7201
Mailing address
18909 Villa Ter
Hagerstown, MD 21742-5310
Phone (240) 625-3600
Other practice location 1
4640 Wedgewood Blvd Ste And105
Frederick, MD 21703-7114
Phone (240) 457-9558
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A5619 | MD | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1643760000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643760000000",
"number": "1902559586",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18909 VILLA TER",
"city": "HAGERSTOWN",
"state": "MD",
"postal_code": "217425310",
"telephone_number": "240-625-3600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1045 MARYLAND AVE",
"city": "HAGERSTOWN",
"state": "MD",
"postal_code": "217407201",
"telephone_number": "301-739-5437"
}
],
"practiceLocations": [
{
"address_1": "4640 Wedgewood Blvd Ste And105",
"address_purpose": "LOCATION",
"city": "Frederick",
"state": "MD",
"postal_code": "217037114",
"country_code": "US",
"telephone_number": "240-457-9558",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MOODY",
"first_name": "MICHAELA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-02-02",
"last_updated": "2022-02-02",
"certification_date": "2022-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MD",
"license": "A5619",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hagerstown, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.