Joe E Moore, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2008002441 Issued in MO

Practice address

780 Prairie Hollow Rd
Ozark, MO 65721-7471

Phone

(417) 300-4064

NPI assigned

Nov 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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 and National Provider Directory roles.

• Great Lakes Physical Therapy, LLC

  • Physical Therapist
  • Sheboygan, WI
  • NPI 1124105028
  NPD (past) Authorized official

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601337600000",
    "number": "1699852442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 PRAIRIE HOLLOW RD",
            "city": "OZARK",
            "state": "MO",
            "postal_code": "657217471",
            "telephone_number": "417-300-4064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 PRAIRIE HOLLOW RD",
            "city": "OZARK",
            "state": "MO",
            "postal_code": "657217471",
            "telephone_number": "417-300-4064"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3303 Superior Ave",
            "address_purpose": "LOCATION",
            "city": "Sheboygan",
            "state": "WI",
            "postal_code": "530811861",
            "country_code": "US",
            "telephone_number": "920-208-3557",
            "fax_number": "920-208-3527",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JOE",
        "middle_name": "E",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-09-29",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2008002441",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "4746-024",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0007725040",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40318700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mobile X-Ray Services LLC (Kosma Mobile X-Ray Co)
• Mobile X-Ray Services, LLC (Kosma Mobile X-Ray)
• Tegan Anne Monnig
• Montgomery Optics, LLC (Visionary Eye Center)
• Pamela J Montgomery
• Royce David Moore, M.D.
• Alexis Morelan
• Crystal Moser, RDH
• Whitney Moser, NP
• Wesley Clark Mullen, DDS

• Physical Therapist in Ozark, MO
• Providers in Ozark, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2020; 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.