Michael Shane Moore, LPTA

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

PTA9712 Issued in AL

Practice address

2757 Vandy CT
Montgomery, AL 36110-1339

Phone

(334) 669-1430

NPI assigned

Aug 17, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Specialty

Physical Therapist in Private Practice

Education

Other, 2024

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Moore Healing LLC

  • Physical Therapist
  • Montgomery, AL
  • NPI 1598626087
  NPD Authorized official

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

{
    "created_epoch": "1597622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597622400000",
    "number": "1972115582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2757 VANDY CT",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361101339",
            "telephone_number": "334-669-1430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2757 VANDY CT",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361101339",
            "telephone_number": "334-669-1430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MICHAEL",
        "middle_name": "SHANE",
        "credential": "LPTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-08-17",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "AL",
            "license": "PTA9712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isaac Moore, LPC
• Jennifer Massey Moore, FNP-C
• Kristin Moore, MSW, LCSW
• Mariel Dees Moore
• Melissa S Moore
• Paul Beveridge Moore, M.D.
• Thomas Saunders Moore, M.D.
• John D Moorehouse, MD
• Dana Moorer, CNM
• Karla Algarin Morales, LICSW

• Physical Medicine & Rehabilitation Physician in Montgomery, AL
• Providers in Montgomery, AL by specialty
• Physical Medicine & Rehabilitation Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2020; 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.