Individual provider Active NPI

Brian Thomas Moore, PT, DPT

  • Physical Therapist
  • Gainesville, GA
National Provider Identifier
1417171695
Registry record updated Sep 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT8758 Issued in GA
Practice address
1640 Jesse Jewell Pkwy SE
Gainesville, GA 30501
Phone
(770) 536-9300
Fax
(770) 536-9389
NPI assigned
Apr 12, 2007
Last updated
Sep 24, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2026

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 PT8758 GA Primary

Addresses

Primary practice location

1640 Jesse Jewell Pkwy SE
Gainesville, GA 30501

Mailing address

2400 Wisteria Dr
Snellville, GA 30078-2689
Phone (770) 982-0102

Other practice location 1

134 Ansley Dr Ste 800
Dahlonega, GA 30533-1641
Phone (770) 982-0102

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110505000438 GA Practitioner - Physical Therapist in Private Practice 5395920482 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

145 Forest Blvd
Suite 200
Dawsonville, GA 30534-7878
Phone (706) 203-2100

2800 Buford Dr
Suite 315
Buford, GA 30519-5107
Phone (678) 450-9933

448 W Kytle St
Suite C
Cleveland, GA 30528-1392
Phone (706) 493-6770

7378 Friendship Springs Blvd
Suite a
Flowery Branch, GA 30542-5547
Phone (678) 318-8030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT8758GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanta Rehabilitation and Performance Center CurrentSince Apr 11, 2011 Accepting new patients
Resurgens, LLC CurrentSince Sep 1, 2025 Accepting new patients
Resurgens, LLC CurrentSince Sep 1, 2025 Accepting new patients
Atlanta Rehabilitation and Performance Center CurrentSince Apr 11, 2011 Accepting new patients

Locations

3155 North Point Pkwy
Ste D100
Alpharetta, GA 30005
Phone (770) 475-7272

5553 Peachtree Rd
Ste 105
Chamblee, GA 30341
Phone (770) 687-2160

225 Adams Dr
Ste D
Demorest, GA 30535
Phone (706) 754-3067

7378 Friendship Springs Blvd
Ste A
Flowery Branch, GA 30542
Phone (678) 318-8030

2350 Limestone Pkwy
Gainesville, GA 30501
Phone (770) 534-5154

335 Roselane St NW
Ste 201
Marietta, GA 30060
Phone (470) 259-5226

4220 Mundy Mill Pl
Ste 2B
Oakwood, GA 30566
Phone (678) 450-9933

528 Valley Hill Rd SW
Riverdale, GA 30274
Phone (678) 712-3072

5671 Ptree Dunwoody Rd NE
Ste 700
Sandy Springs, GA 30342
Phone (404) 459-3732

5671 Ptree Dunwoody Rd NE
Ste 900
Sandy Springs, GA 30342
Phone (404) 531-8590

2400 Wisteria Dr
Ste A
Snellville, GA 30078
Phone (770) 982-0102

295 Molly Ln
Ste 140
Woodstock, GA 30189
Phone (770) 517-2288

Interoperability endpoints

  • Direct secure messaging: brian.moore.1@15749.direct.athenahealth.com

Organizations & group practices 4

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": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790208000000",
    "number": "1417171695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 WISTERIA DR",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300782689",
            "telephone_number": "770-982-0102",
            "fax_number": "770-982-0130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 JESSE JEWELL PKWY SE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "30501",
            "telephone_number": "770-536-9300",
            "fax_number": "770-536-9389"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "134 Ansley Dr Ste 800",
            "address_purpose": "LOCATION",
            "city": "Dahlonega",
            "state": "GA",
            "postal_code": "305331641",
            "country_code": "US",
            "telephone_number": "770-982-0102",
            "fax_number": "770-982-0130",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "BRIAN",
        "middle_name": "THOMAS",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-12",
        "last_updated": "2026-09-24",
        "certification_date": "2026-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT8758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2026; 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.