Individual provider Active NPI

Jennifer Mooty

  • Addiction (Substance Use Disorder) Counselor
  • Ocean City, MD
National Provider Identifier
1962640110
Registry record updated Jan 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
11827 Ocean Gateway
Worcester County Health Department - Wacs Center
Ocean City, MD 21842
Phone
(410) 213-0202
Fax
(410) 213-1408
NPI assigned
Jan 27, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Primary

Addresses

Primary practice location

11827 Ocean Gateway
Worcester County Health Department - Wacs Center
Ocean City, MD 21842

Mailing address

941 Sumac Cir
Salisbury, MD 21804-7906
Phone (410) 251-5200

Other identifiers 1

IdentifierTypeStateIssuer
705371101MedicaidMD

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

NPI Registry JSON

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

{
    "created_epoch": "1233014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233014400000",
    "number": "1962640110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "941 SUMAC CIR",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218047906",
            "telephone_number": "410-251-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11827 OCEAN GATEWAY",
            "address_2": "WORCESTER COUNTY HEALTH DEPARTMENT - WACS CENTER",
            "city": "OCEAN CITY",
            "state": "MD",
            "postal_code": "21842",
            "telephone_number": "410-213-0202",
            "fax_number": "410-213-1408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOOTY",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-27",
        "last_updated": "2009-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "705371101",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocean City, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2009; 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.