Individual provider Active NPI

Christina Lynn Moore, DPT

  • Physical Therapist
  • Sarasota, FL
National Provider Identifier
1205109311
Registry record updated Sep 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT-27154 Issued in FL
Practice address
2970 University Pkwy Ste 105
Sarasota, FL 34243-2401
Phone
(941) 360-1988
NPI assigned
Feb 21, 2012
Last updated
Sep 10, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT-27154 FL Primary

Addresses

Primary practice location

2970 University Pkwy Ste 105
Sarasota, FL 34243-2401

Mailing address

293 Adamo Way
West Melbourne, FL 32904-5114
Phone (770) 365-7756

Other practice location 1

709 S Harbor City Blvd
Suite 100
Melbourne, FL 32901-1938
Phone (321) 725-2225

Other practice location 2

5968 Clark Center Ave
Sarasota, FL 34238-2715
Phone (941) 870-3630

Other identifiers 1

IdentifierTypeStateIssuer
PT-27154OtherFLPT LICENSE

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT-27154FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Maxider Corporation Physical Therapist CurrentSince Aug 6, 2020 Accepting new patients

Locations

2970 University Pkwy
Ste 105
Sarasota, FL 34243
Phone (941) 360-1988

Networks

  • Freedom Health HMO Network

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1329782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599696000000",
    "number": "1205109311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "293 ADAMO WAY",
            "city": "WEST MELBOURNE",
            "state": "FL",
            "postal_code": "329045114",
            "telephone_number": "770-365-7756",
            "fax_number": "941-360-1998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2970 UNIVERSITY PKWY STE 105",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342432401",
            "telephone_number": "941-360-1988"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "709 S Harbor City Blvd",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Melbourne",
            "state": "FL",
            "postal_code": "329011938",
            "country_code": "US",
            "telephone_number": "321-725-2225",
            "fax_number": "321-308-0635",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5968 Clark Center Ave",
            "address_purpose": "LOCATION",
            "city": "Sarasota",
            "state": "FL",
            "postal_code": "342382715",
            "country_code": "US",
            "telephone_number": "941-870-3630",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "CHRISTINA",
        "middle_name": "LYNN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-21",
        "last_updated": "2020-09-10",
        "certification_date": "2020-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT-27154",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE",
            "identifier": "PT-27154",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2020; 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.