Troy Lance Moore, MPT, ATC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11-03659 Issued in KS

Practice address

300 N Park Ave
Ellinwood, KS 67526-1452

Phone

(620) 564-2548

Fax

(620) 564-2079

NPI assigned

Sep 5, 2006

Last updated

Jan 21, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Central Kansas Orthopedic Group, LLC

  • Durable Medical Equipment & Medical Supplies
  • Great Bend, KS
  • NPI 1144599598
  NPD
• Achieve Rehab, LLC

  • Hand Occupational Therapist
  • Great Bend, KS
  • NPI 1942399167

  Physical Therapist

  NPD (past)
• Wheatland Rehabilitation LLC

  • Occupational Therapist
  • Great Bend, KS
  • NPI 1083656920
  NPD (past)

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1932201357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 N PARK AVE",
            "city": "ELLINWOOD",
            "state": "KS",
            "postal_code": "675261452",
            "telephone_number": "620-564-2548",
            "fax_number": "620-564-2079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N PARK AVE",
            "city": "ELLINWOOD",
            "state": "KS",
            "postal_code": "675261452",
            "telephone_number": "620-564-2548",
            "fax_number": "620-564-2079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "TROY",
        "middle_name": "LANCE",
        "name_prefix": "Mr.",
        "credential": "MPT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-05",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "T-00797",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "11-03659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charlie G Joslin, MD
• Ashley Komarek
• Josh Nicholas Komarek, PARAMEDIC
• Audrey Kim Lewis, PTA
• Allison Louise McAtee, RN
• Jessica Mulch, MS, CCC-SLP
• Brooke Nicole Panning
• Rebecca L Rebel, RN
• Red Haus Pharmacy LLC (The Red Haus Pharmacy)
• Chris Paul Robl

• Physical Therapist in Ellinwood, KS
• Providers in Ellinwood, KS by specialty
• Physical Therapist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2025; 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.