Trista Lynn Moore, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11084 Issued in MN

Practice address

2495 Maplewood Dr Ste 313
Maplewood, MN 55109-1985

Phone

(651) 770-8884

NPI assigned

Aug 23, 2018

Sex

Female

Sole proprietor

No

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 MN

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Family Achievement Center Inc.

  • Occupational Therapist
  • Woodbury, MN
  • NPI 1952411175

  Physical Therapist

  Medicare reassignment NPD
• Functional Integrated Therapy, LTD

  • Rehabilitation Clinic/Center
  • Maplewood, MN
  • NPI 1477640613
  Medicare reassignment NPD

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

{
    "created_epoch": "1534982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541116800000",
    "number": "1467933937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2495 MAPLEWOOD DR STE 313",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2495 MAPLEWOOD DR STE 313",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091985",
            "telephone_number": "651-770-8884"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2101 Wooddale Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "Woodbury",
            "state": "MN",
            "postal_code": "551252933",
            "country_code": "US",
            "telephone_number": "651-738-9888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "TRISTA",
        "middle_name": "LYNN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-23",
        "last_updated": "2018-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "11084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittney Moore, ASL INTERPRETER
• Havona Moore
• Matthew Moore
• Maurice Moore
• Travis Moore, RN
• Chiara Antang Morfaw, CNP
• Sherry A Moriarty, MD
• Jessica Lyn Moritz, CNP, WHNP-BC
• Seiquayia Morris
• Charles Moser, MD

• Physical Therapist in Maplewood, MN
• Providers in Maplewood, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2018; 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.