Bobby Lee Moore Jr., DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5665 Issued in OK

Practice address

249 NW 71St Street
Oklahoma City, OK 73116

Phone

(405) 595-0856

NPI assigned

Oct 18, 2021

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

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Bobby Moore DPT, PLLC

  dba Sideout Sports Physical Therapy

  • Physical Therapy Clinic/Center
  • Oklahoma City, OK
  • NPI 1003504317

  Physical Therapist

  Medicare reassignment NPD Authorized official
• Balanced Care Pain Center PLLC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Midwest City, OK
  • NPI 1285386318
  Medicare reassignment NPD
• Grayson Starbuck, DPT, PLLC

  dba Kinito Physical Therapy

  • Physical Therapist
  • Oklahoma City, OK
  • NPI 1396334082
  Medicare reassignment NPD
• Starbuck Medical LLC

  • Nurse Practitioner
  • Oklahoma City, OK
  • NPI 1770255200
  NPD

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

{
    "created_epoch": "1634515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760054400000",
    "number": "1770246688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18221 CAMBORNE AVE",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730123221",
            "telephone_number": "580-364-3312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "249 NW 71ST STREET",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73116",
            "telephone_number": "405-595-0856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "BOBBY",
        "middle_name": "LEE",
        "name_suffix": "Jr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-18",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "5665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Michelle Moore, M.D.
• Austin Gregory Moore, LMFT
• Barbara Elizabeth Moore, ARNP
• Barbara Ellen Moore
• Benjamin William Moore, MD
• Cambri Moore
• Cameron Moore, HIS
• Candace Moore
• Carol A Moore, PHARM D.
• Carrie Ann Moore

• Physical Therapist in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Physical Therapist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.