Michael Moore, ATC, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA.0012277 Issued in CO

Practice address

3910 S Carefree Cir Ste B
Colorado Springs, CO 80917-3053

Phone

(719) 457-6001

NPI assigned

Nov 22, 2019

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

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": "1574380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675728000000",
    "number": "1578109641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3910 S CAREFREE CIR STE B",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809173053",
            "telephone_number": "719-457-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3910 S CAREFREE CIR STE B",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809173053",
            "telephone_number": "719-457-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MICHAEL",
        "credential": "ATC, PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-22",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "CO",
            "license": "AT.0000502",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CO",
            "license": "PTA.0012277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Machere Moore
• Mackenzie Moore, PT, DPT
• Madison Moore
• Mahala Moore
• Matthew Edward Moore, D.O.
• Michael Curtis Moore, MD
• Michelle Marie Moore, MS
• Nerissa Moore, PHARMD
• Nicholas J.E. Moore, MD
• Patrick James Moore, L.M.P.

• Physical Therapy Assistant in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Physical Therapy Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 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.