Katherine Rose Moore, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

41394 Issued in FL

Practice address

1525 Herbert St Ste 103
Port Orange, FL 32129-6107

Phone

(386) 756-0424

Fax

(386) 756-0425

NPI assigned

Mar 4, 2024

Last updated

Mar 4, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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 NJ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Wellness Centers of South Jersey LLCGroup PAC ID 2062862766, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network

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.

• Wellness Centers of South Jersey LLC

  dba FYZICAL Therapy & Balance Centers

  • Physical Therapist
  • Somers Point, NJ
  • NPI 1811773385
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1709510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709510400000",
    "number": "1215794524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 S WILLIAMSON BLVD APT 5-308",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321286549",
            "telephone_number": "609-774-5277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 HERBERT ST STE 103",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321296107",
            "telephone_number": "386-756-0424",
            "fax_number": "386-756-0425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "KATHERINE",
        "middle_name": "ROSE",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-04",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "41394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Montgomery, ARNP
• Moore & Menneto Chiropractic, PLLC
• Moore Chiropractic, PLLC
• Angela Leigh Moore, D.C.
• Cynthia Moore
• Sidney Celine Moore, PHYSICIAN ASSISTANT
• Vijay J Moradia, MD
• Carla Cantinho Morales, LMHC
• Courtney Moreno
• Matthew Morgan

• Physical Therapist in Port Orange, FL
• Providers in Port Orange, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2024; 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.