Stephen Benjamin Moore, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5609 Issued in AR

Practice address

438 E Millsap Rd Ste 205
Fayetteville, AR 72703-4814

Phone

(479) 582-7213

Fax

(479) 435-2204

NPI assigned

Feb 27, 2025

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 AR

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medical Associates of Northwest Arkansas, PAGroup PAC ID 3678542073, 102 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Medical Associates of Northwest Arkansas, PA

  • Internal Medicine Physician
  • Fayetteville, AR
  • NPI 1801847827
  Medicare reassignment Care Compare group NPD
• Medical Associates of Northwest Arkansas PA

  • Diagnostic Radiology Physician
  • Fayetteville, AR
  • NPI 1134170160
  NPD
• Medical Associates of Northwest Arkansas PA

  • Family Medicine Physician
  • Lowell, AR
  • NPI 1912883273
  NPD
• Medical Associates of Northwest Arkansas PA

  • Podiatrist
  • Fayetteville, AR
  • NPI 1164140729
  NPD (past)
• Medical Associates of Northwest Arkansas PA

  • Physical Therapist
  • Fayetteville, AR
  • NPI 1609206325
  NPD (past)
• Medical Associates of Northwest Arkansas PA

  • Family Medicine Physician
  • Fayetteville, AR
  • NPI 1710218995
  NPD (past)

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

{
    "created_epoch": "1740614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777852800000",
    "number": "1780481606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1523",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727021523",
            "telephone_number": "479-571-6038",
            "fax_number": "479-582-0222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "438 E MILLSAP RD STE 205",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034814",
            "telephone_number": "479-582-7213",
            "fax_number": "479-435-2204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "STEPHEN",
        "middle_name": "BENJAMIN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-02-27",
        "last_updated": "2026-05-04",
        "certification_date": "2026-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "5609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bradley Dale Moore, MHPP
• James Franklin Moore, M.D.
• Laquisha R Moore, BS, QBHP
• Melissa Moore
• Sarah Moore, LPC
• Tasha Moore
• Tyler Forest Moore, M.S.
• Unique Moore
• Ismael Gbolahan Moradeyo, DO
• Esabel Moran, RBT

• Physical Therapist in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Physical Therapist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.