Susan P Moore, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT4201 Issued in FL

Practice address

4747 N Ocean Dr
Ste 261
Lauderdale by the Sea, FL 33308-2947

Phone

(954) 785-4776

NPI assigned

Feb 20, 2009

Last updated

Feb 20, 2009By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Sea Ranch Physical Therapy Center Inc

  • Physical Therapy Clinic/Center
  • Key Largo, FL
  • NPI 1992847479
  NPD (past)

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

{
    "created_epoch": "1235088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235088000000",
    "number": "1659511350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2725 NE 25TH PL",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333051705",
            "telephone_number": "954-561-6962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4747 N OCEAN DR",
            "address_2": "STE 261",
            "city": "LAUDERDALE BY THE SEA",
            "state": "FL",
            "postal_code": "333082947",
            "telephone_number": "954-785-4776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "SUSAN",
        "middle_name": "P",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-20",
        "last_updated": "2009-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT4201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "PT4201",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carmen Maco, D.M.D
• Susan Marinelli, OTR
• Meridian Treatment Solutions, Inc
• Michael a. Abraham D.M.D., PA
• Mind's Eye Day Spa Inc. (Meds Clinic)
• Amy Cohen Nehrke, PT
• New Paradigm Health
• Oband Medical Group
• Ocean Manor Professional Group LLC
• Ocean Medical Walk-in Clinic

• Physical Therapist in Lauderdale by the Sea, FL
• Providers in Lauderdale by the Sea, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2009; 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.