Mark W Moore, MPT, CWS

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

7954 Issued in AZ

Practice address

6036 N 19TH Ave Ste 303
Phoenix, AZ 85015

Phone

(602) 795-8441

Fax

(602) 795-8447

NPI assigned

Oct 23, 2006

Last updated

Sep 11, 2025By 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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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

• Fleur de Lis Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • New Orleans, LA
  • NPI 1134204167

  Physical Therapist

  NPD (past) Authorized official
• Magnolia Physical Therapy, LLC

  • Physical Therapist
  • Harahan, LA
  • NPI 1316083447
  NPD (past)
• Vista Rehab Partners, LP

  dba Vista Physical Therapy

  • Physical Therapist
  • Prosper, TX
  • NPI 1659716462
  NPD (past)

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1588747588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 ELDORADO PKWY # 102-20",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750706510",
            "telephone_number": "214-346-9105",
            "fax_number": "214-346-9125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6036 N 19TH AVE STE 303",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85015",
            "telephone_number": "602-795-8441",
            "fax_number": "602-795-8447"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6036 N 19th Ave Ste 303",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850152105",
            "country_code": "US",
            "telephone_number": "602-795-8441",
            "fax_number": "602-795-8447",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MARK",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "credential": "MPT, CWS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "7954",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS BOARD OF PHYSICAL THERAPISTS",
            "identifier": "1145845",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "305782",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathleen Sullivan Moore
• Laura Simchak Moore, MPT
• Lawrence Christopher Moore
• Lindsay Cota Moore, PT, DPT
• Logan Moore, PHARMD
• Meagan Moore, ND
• Mercedes Moore
• Michael Moore, CCP
• Michael Moore
• Monica Moore

• Physical Therapist in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.