NPIMap

Organization Active NPI

Gregory Todd Moore, DO PA

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Mansfield, TX
National Provider Identifier
1295961233
Registry record updated Nov 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
N0287 Issued in TX
Legal business name
GREGORY TODD MOORE, DO PA
Practice address
1320 Highway 287 S
Mansfield, TX 76063-5701
Phone
(817) 968-5806
Fax
(915) 703-7745
NPI assigned
Jun 4, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2025

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

Authorized official

Name
Kate Kiser
Title
Practice Manager
Phone
(817) 529-1900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207XX0005X N0287 TX Primary

Addresses

Primary practice location

1320 Highway 287 S
Mansfield, TX 76063-5701

Mailing address

2901 Acme Brick PLZ
Fort Worth, TX 76109-4124
Phone (817) 529-1900

Other names 1

  • Ellis County Orthopedic Sports Medicine Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090911000301 TX Part B Supplier - Clinic/Group Practice 5597810739 Receives reassigned benefits from 1 practitioner
Practice locations: Mansfield, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1244073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762300800000",
    "number": "1295961233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 ACME BRICK PLZ",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761094124",
            "telephone_number": "817-529-1900",
            "fax_number": "817-529-1910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 HIGHWAY 287 S",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760635701",
            "telephone_number": "817-968-5806",
            "fax_number": "915-703-7745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREGORY TODD MOORE, DO PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-04",
        "last_updated": "2025-11-05",
        "certification_date": "2025-11-05",
        "status": "A",
        "authorized_official_last_name": "KISER",
        "authorized_official_first_name": "KATE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "817-529-1900"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "TX",
            "license": "N0287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ellis County Orthopedic Sports Medicine Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ellis County Orthopedic Sports Medicine Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mansfield, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2025; 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.