Individual provider Active NPI

Juana Ki Moody, MS, ATC

  • Athletic Trainer
  • Newtown, PA
National Provider Identifier
1982830204
Registry record updated Jun 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
RT001215A Issued in PA
Practice address
1690 Newtown Langhorne Rd
PMB 4006
Newtown, PA 18940-2414
Phone
(610) 348-0467
NPI assigned
Jun 1, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X RT001215A PA Primary

Addresses

Primary practice location

1690 Newtown Langhorne Rd
PMB 4006
Newtown, PA 18940-2414

Mailing address

1690 Newtown Langhorne Rd
PMB 4006
Newtown, PA 18940-2414
Phone (610) 348-0467

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
RT001215APAMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1243814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433116800000",
    "number": "1982830204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1690 NEWTOWN LANGHORNE RD",
            "address_2": "PMB 4006",
            "city": "NEWTOWN",
            "state": "PA",
            "postal_code": "189402414",
            "telephone_number": "610-348-0467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1690 NEWTOWN LANGHORNE RD",
            "address_2": "PMB 4006",
            "city": "NEWTOWN",
            "state": "PA",
            "postal_code": "189402414",
            "telephone_number": "610-348-0467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOODY",
        "first_name": "JUANA",
        "middle_name": "KI",
        "credential": "MS, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-01",
        "last_updated": "2015-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "PA",
            "license": "RT001215A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newtown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2015; 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.