Kathleen M Moore, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

001672 Issued in WV

Practice address

50 Mulberry Tree St
Charles Town, WV 25414-1274

Phone

(304) 724-1101

NPI assigned

Apr 25, 2012

Sex

Female

Sole proprietor

Yes

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

State licenses

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

{
    "created_epoch": "1335312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335312000000",
    "number": "1790043974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 FRYE CT",
            "city": "LOVETTSVILLE",
            "state": "VA",
            "postal_code": "201808619",
            "telephone_number": "540-822-5458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 MULBERRY TREE ST",
            "city": "CHARLES TOWN",
            "state": "WV",
            "postal_code": "254141274",
            "telephone_number": "304-724-1101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "KATHLEEN",
        "middle_name": "M",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-25",
        "last_updated": "2012-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WV",
            "license": "001672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Corry Lynn Miller, PTA
• Steven C. Miniberg, LPC
• Veneranda Miranda
• Alicia Mongold
• Anne Victoria Monson, CPM
• Lee Richard Moore Jr., O.D.
• Keegan Moriarty
• Misty Dawn Morningstar
• Amy Morris, SLP
• Kaitlin Morris

• Physical Therapy Assistant in Charles Town, WV
• Providers in Charles Town, WV by specialty
• Physical Therapy Assistant in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2012; 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.