Tesa Moore, PTA

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

PTA-4985 Issued in OH

Practice address

12340 State Route 104
Waverly, OH 45690-8968

Phone

(740) 941-5170

NPI assigned

Jan 16, 2025

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

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": "1736985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1548071897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1534 PLEASANT HILL RD",
            "city": "WAVERLY",
            "state": "OH",
            "postal_code": "456909217",
            "telephone_number": "740-705-0780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12340 STATE ROUTE 104",
            "city": "WAVERLY",
            "state": "OH",
            "postal_code": "456908968",
            "telephone_number": "740-941-5170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "TESA",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-16",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "OH",
            "license": "PTA-4985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Elaine Moore, NP
• Jenna Moore
• Jerri Dawn Moore
• Roger Moore
• Sarah Moore
• Stacy Davis Moorman, DDS
• Christy Moraleja
• Ahmed M Mosalem, M.D
• Heather Renee Mullins, CDCA
• Deanna Mundy

• Physical Medicine & Rehabilitation Physician in Waverly, OH
• Providers in Waverly, OH by specialty
• Physical Medicine & Rehabilitation Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; 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.