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VALERIE JEAN MOODY ATC
Complete NPI Record 1750642740
Specialist/Technologist - Athletic Trainer in Missoula, MT

NPI Status: Active since June 06, 2012

Contact Information

32 CAMPUS DR
MCGILL HALL 238C
MISSOULA, MT
ZIP 59812
Phone: (406) 243-2703

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Provider Last Name Legal Name
  4. Provider First Name
  5. Provider Middle Name
  6. Provider Credential Text
  7. Provider First Line Business Mailing Address
  8. Provider Business Mailing Address City Name
  9. Provider Business Mailing Address State Name
  10. Provider Business Mailing Address Postal Code
  11. Provider Business Mailing Address Country Code If outside U S
  12. Provider First Line Business Practice Location Address
  13. Provider Second Line Business Practice Location Address
  14. Provider Business Practice Location Address City Name
  15. Provider Business Practice Location Address State Name
  16. Provider Business Practice Location Address Postal Code
  17. Provider Business Practice Location Address Country Code If outside U S
  18. Provider Business Practice Location Address Telephone Number
  19. Provider Enumeration Date
  20. Last Update Date
  21. Provider Gender Code
  22. Healthcare Provider Taxonomy Code 1
  23. Provider License Number 1
  24. Provider License Number State Code 1
  25. Healthcare Provider Primary Taxonomy Switch 1
  26. Is Sole Proprietor

Complete NPI Dataset

This page represents the complete record for NPI 1750642740. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1750642740
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 1
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
The city name in the location address of the provider being identified.
Provider First Name: VALERIE
The State code in the location of the provider being identified.
Provider Middle Name: JEAN
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Credential Text: ATC
The country code in the location address of the provider being identified.
Provider First Line Business Mailing Address: 5505 COTTONWOOD DR S
The telephone number associated with the location address of the provider being identified.
Provider Business Mailing Address City Name: FLORENCE
The date the provider was assigned a unique identifier (assigned an NPI).
Provider Business Mailing Address State Name: MT
The date that a record was last updated or changed.
Provider Business Mailing Address Postal Code: 598336627
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Provider Business Mailing Address Country Code If outside U S : US
The first name of the authorized official.
Provider First Line Business Practice Location Address: 32 CAMPUS DR
The middle name of the authorized official.
Provider Second Line Business Practice Location Address: MCGILL HALL 238C
The title or position of the authorized official.
Provider Business Practice Location Address City Name: MISSOULA
The 10-position telephone number of the authorized official.
Provider Business Practice Location Address State Name: MT
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider Business Practice Location Address Postal Code: 598120003
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider Business Practice Location Address Country Code If outside U S : US
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Provider Business Practice Location Address Telephone Number: 4062432703
The telephone number associated with the location address of the provider being identified.
Provider Enumeration Date: 6/6/2012
Last Update Date: 6/6/2012
Provider Gender Code: F
The code designating the provider’s gender if the provider is a person.
Healthcare Provider Taxonomy Code 1: 2255A2300X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 1: 24ATR
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 1: MT
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 1: Y
Is Sole Proprietor: Y
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No