NPIMap

Organization Active NPI

Moore Therapeutic Services LLC

  • Physical Therapy Clinic/Center
  • Wilmington, DE
National Provider Identifier
1245485325
Registry record updated Feb 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
2003104444 Issued in DE
Legal business name
MOORE THERAPEUTIC SERVICES LLC
Practice address
1806 N Van Buren St
Suite 110
Wilmington, DE 19802-3851
Phone
(484) 459-1851
NPI assigned
Nov 17, 2008
Last updated
Feb 2, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2009

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

Authorized official

Name
Mr. Shaun Michael Moore, P.T.NPI 1164495271
Title
President/Owner
Phone
(484) 459-1851

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 2003104444 DE Primary

Addresses

Primary practice location

1806 N Van Buren St
Suite 110
Wilmington, DE 19802-3851

Mailing address

3317 Tunison Dr
Wilmington, DE 19810-3225
Phone (484) 459-1851

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090206000198 DE Part B Supplier - Clinic/Group Practice 8921162918 Receives reassigned benefits from 3 practitioners
Practice locations: Wilmington, DE

National Provider Directory

National Provider Directory

Locations

701 Foulk Rd
Ste 2D
Wilmington, DE 19803
Phone (302) 654-8142

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1226880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233532800000",
    "number": "1245485325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3317 TUNISON DR",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198103225",
            "telephone_number": "484-459-1851",
            "fax_number": "302-478-7544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1806 N VAN BUREN ST",
            "address_2": "SUITE 110",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198023851",
            "telephone_number": "484-459-1851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOORE THERAPEUTIC SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-17",
        "last_updated": "2009-02-02",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "SHAUN",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "484-459-1851",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "DE",
            "license": "2003104444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.