Andi Moore, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

4634 Issued in AR

Practice address

700 N College Ave
El Dorado, AR 71730-4404

Phone

(870) 863-8131

NPI assigned

Jun 30, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Andi Williams Former name

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jackson Parish Therapy Center, LLCGroup PAC ID 8022048867, 26 clinicians

Practice addresses (Care Compare)

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.

• Jackson Parish Therapy Center LLC

  • Physical Therapist
  • Ruston, LA
  • NPI 1891794491

  AR

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1467244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564444800000",
    "number": "1982055950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 PINECREST RD",
            "city": "ARCADIA",
            "state": "LA",
            "postal_code": "710015219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 N COLLEGE AVE",
            "city": "EL DORADO",
            "state": "AR",
            "postal_code": "717304404",
            "telephone_number": "870-863-8131"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1901 Roselawn Ave",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "LA",
            "postal_code": "712015715",
            "country_code": "US",
            "telephone_number": "318-322-7050",
            "fax_number": "844-273-7017",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ANDI",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-30",
        "last_updated": "2019-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "09418R",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "4634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDI",
            "last_name": "WILLIAMS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Fonda Renee Mitchell, PTA
• Mobley Medical Clinic PLLC
• Jessica P Mobley, APN
• Requebia Monk
• Shakerah Moody
• Darwin Moore
• Michael Riley Moore, BOC P. ABC C.F.O.
• Alyssa Rene Morgan
• James B Morgan, MD
• Shane Morr

• Physical Therapist in El Dorado, AR
• Providers in El Dorado, AR by specialty
• Physical Therapist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.