Active NPI
Ricquavious Moore, DPT
- Physical Therapist
- Tucker, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT018125
- Practice address
- 1459 Montreal Rd Ste 304
Tucker, GA 30084-6920 - Phone
- (706) 832-8400
- NPI assigned
- Dec 7, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | |||
| Physical Therapist | 225100000X | PT018125 | GA | Primary |
Addresses
Primary practice location
1459 Montreal Rd Ste 304
Tucker, GA 30084-6920
Mailing address
1459 Montreal Rd Ste 304
Tucker, GA 30084-6920
Phone (706) 832-8400
Other practice location 1
1110 13th St
Columbus, GA 31901-2246
Phone (706) 221-7139
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PT018125 | Other | GA | LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1459 Montreal Rd
Suite 304
Tucker, GA 30084-6920
Phone (404) 251-3420
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT018125 | GA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emory Physical Therapy, LLC | Current | Accepting new patients | |
| Emory Physical Therapy, LLC | Current | Accepting new patients | |
| Emory Physical Therapy, LLC | Past | Accepting new patients |
Locations
1845 Satellite Blvd
Ste 750
Duluth, GA 30097
Phone (404) 778-6490
1459 Montreal Rd
Ste 304
Tucker, GA 30084
Phone (404) 251-3420
Organizations & group practices 4
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.
-
- Physical Therapy Clinic/Center
- Atlanta, GA
- NPI 1922018423
-
- Physical Therapy Clinic/Center
- Lithonia, GA
- NPI 1346119831
-
- Physical Therapy Clinic/Center
- Brookhaven, GA
- NPI 1720097561
-
- Physical Therapy Clinic/Center
- Duluth, GA
- NPI 1831108695
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1638835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1765497600000",
"number": "1629736665",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1459 MONTREAL RD STE 304",
"city": "TUCKER",
"state": "GA",
"postal_code": "300846920",
"telephone_number": "706-832-8400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1459 MONTREAL RD STE 304",
"city": "TUCKER",
"state": "GA",
"postal_code": "300846920",
"telephone_number": "706-832-8400"
}
],
"practiceLocations": [
{
"address_1": "1110 13th St",
"address_purpose": "LOCATION",
"city": "Columbus",
"state": "GA",
"postal_code": "319012246",
"country_code": "US",
"telephone_number": "706-221-7139",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MOORE",
"first_name": "RICQUAVIOUS",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-12-07",
"last_updated": "2025-12-12",
"certification_date": "2025-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "GA",
"license": "PT018125",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "PT018125",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Tucker, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.