Dane Ellis Moore, ATC, LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT006891 Issued in OH

Practice address

1189 Beall Ave
Wooster, OH 44691-2363

Phone

(608) 548-4335

NPI assigned

Aug 18, 2023

Last updated

Aug 18, 2023By 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 1

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": "1692316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692316800000",
    "number": "1528841897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 PORTAGE RD APT 324",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446911967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1189 BEALL AVE",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446912363",
            "telephone_number": "608-548-4335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "DANE",
        "middle_name": "ELLIS",
        "credential": "ATC, LAT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-18",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OH",
            "license": "AT006891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Moody-Carter
• Michelle Leigh Moody, MSW, LSW
• Mariah Moomaw, PTA
• Moore Chiropractic & Wellness of Wooster, Inc.
• Amber Moore
• Demetri J Moore
• Hayden C Moore, LSW
• Jason L Moore, L.M.T.
• Mariah Elizabeth Moore, LSW
• Marty Jacob Moore, D.C.

• Athletic Trainer in Wooster, OH
• Providers in Wooster, OH by specialty
• Athletic Trainer in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2023; 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.