Mary Moore

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT018667 Issued in OH

Practice address

4647 Monroe St
Toledo, OH 43623-4418

Phone

(567) 290-3500

NPI assigned

Jun 12, 2023

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

Other names 1

• Mary Flischel Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Specialty

Physical Therapist in Private Practice

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• My Wellness Team LLC

  • Physical Therapist
  • Cincinnati, OH
  • NPI 1619651767
  NPD

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

{
    "created_epoch": "1686528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1942984984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6441 TRIPLE CROWN LN",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436152443",
            "telephone_number": "513-508-6749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4647 MONROE ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234418",
            "telephone_number": "567-290-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MARY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-12",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT018667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "FLISCHEL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Khrystyna Moore
• Latisha Renee Moore
• Laura Moore, RN
• Lisa Moore, OT
• Marcella Moore
• Michael E Moore Sr.
• Onnastacia Moore
• Peta-Gaye Moore
• Sean Moore, CRNA
• Sherika M Moore

• Physical Therapist in Toledo, OH
• Providers in Toledo, OH by specialty
• Physical Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.