Mason Lee Moore, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

P21039 Issued in NC

Practice address

9881 Broken Land Pkwy Ste 103
Columbia, MD 21046-3013

Phone

(828) 231-0624

NPI assigned

Feb 10, 2022

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1644451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644451200000",
    "number": "1700530557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "252 FOREST HILL DR",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288032406",
            "telephone_number": "828-231-0624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9881 BROKEN LAND PKWY STE 103",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210463013",
            "telephone_number": "828-231-0624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MASON",
        "middle_name": "LEE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-10",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P21039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drmoore@rehab2perform.com",
            "affiliation": "Y",
            "endpointDescription": "Work email",
            "affiliationName": "Rehab 2 Perform LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "9881 Broken Land Pkwy Ste 103",
            "city": "Columbia",
            "state": "MD",
            "country_code": "US",
            "postal_code": "210463013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jade Moore
• Jeffrey Moore
• Joshua Moore
• Katherine Lea Moore, PH.D.
• Kiersten Moore, MPAS, PA-C
• Nastassia Janee Moore, LMSW
• Richard A Moore Jr.
• Taren J Moore
• Tarjee Moore
• Christopher Mooring

• Physical Therapist in Columbia, MD
• Providers in Columbia, MD by specialty
• Physical Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2022; 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.