Active NPI
Sydney Moore, DPT
- Physical Therapist
- O Fallon, IL
National Provider Identifier
1972410488
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070.040678
- Practice address
- 916 Talon Dr
O Fallon, IL 62269-1848 - Phone
- (618) 628-8211
- Fax
- (618) 628-0883
- NPI assigned
- Aug 27, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070.040678 | IL | Primary |
Addresses
Primary practice location
916 Talon Dr
O Fallon, IL 62269-1848
Mailing address
802 W Madison St
O Fallon, IL 62269-1030
Phone (618) 628-8211
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1787788800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787788800000",
"number": "1972410488",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "802 W MADISON ST",
"city": "O FALLON",
"state": "IL",
"postal_code": "622691030",
"telephone_number": "618-628-8211",
"fax_number": "618-628-0883"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "916 TALON DR",
"city": "O FALLON",
"state": "IL",
"postal_code": "622691848",
"telephone_number": "618-628-8211",
"fax_number": "618-628-0883"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "SYDNEY",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-08-27",
"last_updated": "2026-08-27",
"certification_date": "2026-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070.040678",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in O Fallon, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.