Connie W Moore, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT1290 Issued in MS

Practice address

533B Keyway Dr
Flowood, MS 39232-8809

Phone

(601) 420-0717

NPI assigned

Oct 29, 2013

Last updated

Oct 29, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

University of Mississippi School of Medicine, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Specialized Physical TherapyGroup PAC ID 2769459726, 4 clinicians

Aegis Group Practice LLCGroup PAC ID 5193036432, 399 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Aegis Group Practice LLC

  • Physical Therapist
  • Ridgeland, MS
  • NPI 1881271302
  Medicare reassignment Care Compare group NPD
• Specialized Physical Therapy

  • Physical Therapist
  • Flowood, MS
  • NPI 1346317344
  Medicare reassignment Care Compare group
• Aegis Group Practice LLC

  • Physical Therapist
  • Olive Branch, MS
  • NPI 1275392458
  NPD
• Aegis Group Practice LLC

  • Physical Therapist
  • Indian Harbour Beach, FL
  • NPI 1932072030
  NPD
• Specialized Physical Therapy

  • Physical Therapist
  • Flowood, MS
  • NPI 1134289275
  NPD (past)

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

{
    "created_epoch": "1383004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383004800000",
    "number": "1063840163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "533B KEYWAY DR",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392328809",
            "telephone_number": "601-420-0717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "533B KEYWAY DR",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392328809",
            "telephone_number": "601-420-0717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "CONNIE",
        "middle_name": "W",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-29",
        "last_updated": "2013-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT1290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Momme
• Anna Leigh Montgomery, M.S., SLP
• Lauren B Montgomery, CRNA
• Chakilia Sharee Moody, AGACNP-BC
• Cierra Moore
• Joshua Wayne Moore, DAC. LAC
• Shanu Preetha Moorthy, MD
• Donna Fink Morgan, CRNA
• John L Moriarity, M.D.
• Glenn F Morris, MD

• Physical Therapist in Flowood, MS
• Providers in Flowood, MS by specialty
• Physical Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.