Active NPI
Dylan Tyler Moore, ATC
- Athletic Trainer
- Hays, KS
National Provider Identifier
1750839684
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 24-01132
- Practice address
- 600 Park St # 1
Hays, KS 67601-4009 - Phone
- (785) 628-4000
- NPI assigned
- Sep 20, 2016
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 24-01132 | KS | Primary |
Addresses
Primary practice location
600 Park St # 1
Hays, KS 67601-4009
Mailing address
631 W 9TH St
Concordia, KS 66901-3321
Phone (785) 614-2637
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24-01132 | KS | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1474329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1474329600000",
"number": "1750839684",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "631 W 9TH ST",
"city": "CONCORDIA",
"state": "KS",
"postal_code": "669013321",
"telephone_number": "785-614-2637"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 PARK ST # 1",
"city": "HAYS",
"state": "KS",
"postal_code": "676014009",
"telephone_number": "785-628-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "DYLAN",
"middle_name": "TYLER",
"name_prefix": "Mr.",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-09-20",
"last_updated": "2016-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "KS",
"license": "24-01132",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hays, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.