Sally Moore, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2004022996 Issued in MO

Practice address

1739 Elm CT
Jefferson City, MO 65101-4303

Phone

(573) 681-0445

NPI assigned

Aug 27, 2016

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1472256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472256000000",
    "number": "1730635046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 DEL MAR DR",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651096146",
            "telephone_number": "573-424-0566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1739 ELM CT",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651014303",
            "telephone_number": "573-681-0445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "SALLY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-27",
        "last_updated": "2016-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2004022996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Destri Lora Moffat, OTR/L
• Danielle Sue Moffatt, PT, DPT
• Pamela Monroe
• Elizabeth Ann Moore, PHARMD
• Faith Moore
• Aditi More, MD
• Jeanine K Morehouse, OTR
• Patrick J Morello, MD, FACC
• Shannon N Carpenter Morfeld, LCSW
• Brianne Morgan, CCC-SLP

• Physical Therapist in Jefferson City, MO
• Providers in Jefferson City, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2016; 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.