Individual provider Active NPI

Jeffrey A. Moore, P.T.

  • Physical Therapist
  • Terre Haute, IN
National Provider Identifier
1477758100
Registry record updated Jul 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05002859A Issued in IN
Practice address
1212 S 3Rd St
Terre Haute, IN 47802-1006
Phone
(812) 232-4333
NPI assigned
Jun 21, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2007

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 05002859A IN Primary

Addresses

Primary practice location

1212 S 3Rd St
Terre Haute, IN 47802-1006

Mailing address

2629 E Peggy Ave
Terre Haute, IN 47805-1359
Phone (812) 466-4927

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Aegis Group Practice LLC Physical Therapist CurrentSince Mar 3, 2023 Accepting new patients
Aegis Group Practice LLC Physical Therapist CurrentSince Mar 3, 2023 Accepting new patients
Aegis Group Practice LLC Physical Therapist Current Accepting new patients

Locations

4933 Old Greenwood Rd
Fort Smith, AR 72903

98 N 10th St
Greencastle, IN 46135
Phone (765) 301-4642

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1182384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184025600000",
    "number": "1477758100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2629 E PEGGY AVE",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478051359",
            "telephone_number": "812-466-4927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 S 3RD ST",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478021006",
            "telephone_number": "812-232-4333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JEFFREY",
        "middle_name": "A.",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-21",
        "last_updated": "2007-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05002859A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Terre Haute, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2007; 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.