Individual provider Active NPI

Barbara Ann Moeller, OTR

  • Occupational Therapist
  • Madison, WI
National Provider Identifier
1962624171
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2834-026 Issued in WI
Practice address
6201 Mineral Point Rd # 09
Madison, WI 53705-4503
Phone
(608) 231-3451
Fax
(608) 231-1504
NPI assigned
May 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 2834-026 WI Primary

Addresses

Primary practice location

6201 Mineral Point Rd # 09
Madison, WI 53705-4503

Mailing address

819 Hemlock Dr
Verona, WI 53593-1614
Phone (608) 848-1748

Other identifiers 1

IdentifierTypeStateIssuer
40860900MedicaidWI

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

LicenseStateTypeSpecialty
2834-026WIMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962624171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "819 HEMLOCK DR",
            "city": "VERONA",
            "state": "WI",
            "postal_code": "535931614",
            "telephone_number": "608-848-1748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6201 MINERAL POINT RD # 09",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537054503",
            "telephone_number": "608-231-3451",
            "fax_number": "608-231-1504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOELLER",
        "first_name": "BARBARA",
        "middle_name": "ANN",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "2834-026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40860900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.