Kristen Moore, PT, DPT

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

PT298104 Issued in CA

Practice address

1910 Old Tustin Ave
Santa Ana, CA 92705-7811

Phone

(714) 835-6638

NPI assigned

Aug 12, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kristen Coffman Former name

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 and National Provider Directory roles.

• Davis and Watson Physical Therapy Inc.

  • Orthopedic Physical Therapist
  • Santa Ana, CA
  • NPI 1629015425

  Neurology

  NPD
• Venkat Devineni, MD, Inc

  • Medical Specialty Clinic/Center
  • Victorville, CA
  • NPI 1619108164
  NPD (past)

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

{
    "created_epoch": "1597190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597190400000",
    "number": "1942811062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 OLD TUSTIN AVE",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927057811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 OLD TUSTIN AVE",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927057811",
            "telephone_number": "714-835-6638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "KRISTEN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-12",
        "last_updated": "2020-08-12",
        "certification_date": "2020-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251N0400X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Neurology",
            "state": "CA",
            "license": "PT298104",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "PT298104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "COFFMAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brian Vincent Moore, RN
• Cody J Moore
• Debra Renee Moore, ASW
• Hannah N Moore
• Kimberely Moore
• Maria Cristina Moore, RN
• Mia Monica Moore
• Sarah Grace Moore
• Shelby Moore
• Stephanie Moore, PSYD

• Orthopedic Physical Therapist in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• Orthopedic Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2020; 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.