Christopher Anthony Moore, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

110058 Issued in IA

Practice address

610 W 4TH St
Storm Lake, IA 50588-1713

Phone

(712) 749-2254

NPI assigned

Sep 2, 2019

Last updated

Jan 2, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1567382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704153600000",
    "number": "1316595432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5935 TANNER LN",
            "city": "STEWARTSTOWN",
            "state": "PA",
            "postal_code": "173638406",
            "telephone_number": "717-916-2970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 W 4TH ST",
            "city": "STORM LAKE",
            "state": "IA",
            "postal_code": "505881713",
            "telephone_number": "712-749-2254"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "402 E College St",
            "address_purpose": "LOCATION",
            "city": "Bridgewater",
            "state": "VA",
            "postal_code": "228121511",
            "country_code": "US",
            "telephone_number": "540-828-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "CHRISTOPHER",
        "middle_name": "ANTHONY",
        "credential": "LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-02",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IA",
            "license": "110058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Kay Miller
• Casey C Miller, D.C.
• Korissa Ann Minton
• Monteer Dialysis LLC (Renal Center of Storm Lake)
• Rebecca Kay Mooney, PMHNP
• Morris Chiropractic
• Tanner Morris, DC
• Jason John Munden, DPT
• Kathleen Munden, PHYSICAL THERAPIST
• Miguel Munilla, D.D.S.

• Athletic Trainer in Storm Lake, IA
• Providers in Storm Lake, IA by specialty
• Athletic Trainer in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2024; 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.