Sandra Lynn Moore, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

4935 Issued in NC

Practice address

170 Kimel Park Dr
Winston Salem, NC 27103-6946

Phone

(336) 768-1270

Fax

(336) 765-6375

NPI assigned

Jul 26, 2006

Last updated

Apr 10, 2008By the provider in NPPES

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

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Orthopaedic Specialists of the Carolinas, P.a.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Winston Salem, NC
  • NPI 1124070115
  NPD (past)

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207785600000",
    "number": "1861415978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25626",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271145626",
            "telephone_number": "336-768-1270",
            "fax_number": "336-765-6375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 KIMEL PARK DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036946",
            "telephone_number": "336-768-1270",
            "fax_number": "336-765-6375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "SANDRA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2008-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "4935",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC PROVIDER #",
            "identifier": "6400324",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST PROVIDER #",
            "identifier": "97886",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER #",
            "identifier": "0777F",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE MEDICARE PROVIDER #",
            "identifier": "808047",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PROVIDER #",
            "identifier": "P0005866",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Luke Moore
• Madeline Moore
• Michelle Lynn Moore, PAC
• Natalie Marie Moore
• Phillip Schmitz Moore, MD
• Sydney Moore, LCMHCA
• Theresa Lynn Moore, PMHNP-BC
• Timothy Joseph Moore, MD
• Tonya Michelle Moore, MS, NCC, LPC
• Wendy Colleen Moore, MD

• Physical Therapist in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2008; 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.