Individual provider Active NPI

Brittany J Moore, MD

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Overland Park, KS
National Provider Identifier
1861810137
Registry record updated Sep 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X
License
04-43431 Issued in KS
Practice address
10777 Nall Ave Ste 300
Overland Park, KS 66211-1330
Phone
(913) 642-0200
Fax
(913) 563-6699
NPI assigned
Apr 2, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X 2020031452 MO
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X 04-43431 KS Primary

Addresses

Primary practice location

10777 Nall Ave Ste 300
Overland Park, KS 66211-1330

Mailing address

10777 Nall Ave Ste 300
Overland Park, KS 66211-1330
Phone (913) 642-0200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, MO2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200709001017 KS Practitioner - Physical Medicine and RehabilitationPractitioner - Sports Medicine 9931417656 Reassigns benefits to 1 organization
I20200929002325 MO Practitioner - Physical Medicine and RehabilitationPractitioner - Sports Medicine 9931417656 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Sports Medicine
Education
University of Kansas School of Med (KC/Wich/Sal), 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

Practice addresses (Care Compare)

100 E Kansas St
Lansing, KS 66043-1610
Phone (913) 758-0283

10777 Nall Ave
Suite 300
Overland Park, KS 66211-1330
Phone (913) 642-0200

17067 S Outer Rd
Suite 301
Belton, MO 64012-2155
Phone (913) 642-0200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Dickson Diveley Midwest Orthopaedic Clinic LLC Sports Medicine CurrentSince Jul 1, 2021 Accepting new patients
Dickson Diveley Midwest Orthopaedic Clinic LLC Sports Medicine CurrentSince Jul 1, 2021 Accepting new patients

Locations

3651 W 111th St
Overland Park, KS 66211
Phone (800) 876-5958

10777 Nall Ave
Ste 300
Overland Park, KS 66211
Phone (913) 257-6259

7450 Kessler St
Ste 140
Shawnee Mission, KS 66204
Phone (913) 319-7600

17067 S Outer Rd
Ste 301
Belton, MO 64012
Phone (913) 257-6259

201 W Road Mize Rd
Ste 200
Blue Springs, MO 64014
Phone (913) 319-7600

4320 Wornall Rd
Ste 610
Kansas City, MO 64111
Phone (913) 319-7600

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1396396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664496000000",
    "number": "1861810137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10777 NALL AVE STE 300",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111330",
            "telephone_number": "913-642-0200",
            "fax_number": "913-563-6699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10777 NALL AVE STE 300",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111330",
            "telephone_number": "913-642-0200",
            "fax_number": "913-563-6699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "BRITTANY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-02",
        "last_updated": "2022-09-30",
        "certification_date": "2022-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "MO",
            "license": "2020031452",
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "KS",
            "license": "04-43431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

Verify at the official NPI Registry.