Amanda Martin Moore, D.P.T., OT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT009863 Issued in GA

Practice address

3328 Bemiss Rd
Valdosta, GA 31605-7014

Phone

(229) 244-1201

Fax

(229) 244-1207

NPI assigned

Jun 4, 2010

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

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Valdosta Health & Wellness Clinic Inc

  • Adult Health Nurse Practitioner
  • Valdosta, GA
  • NPI 1366840258
  NPD

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

{
    "created_epoch": "1275609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390521600000",
    "number": "1982924635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3328 BEMISS RD",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316057014",
            "telephone_number": "229-244-1201",
            "fax_number": "229-244-1207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3328 BEMISS RD",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316057014",
            "telephone_number": "229-244-1201",
            "fax_number": "229-244-1207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "AMANDA",
        "middle_name": "MARTIN",
        "credential": "D.P.T., OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-04",
        "last_updated": "2014-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT009863",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT005039",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Myan Simone Montgomery
• Raymond Avery Moody III, D.O.
• Patrick Moon, DPT
• Adam Rhett Moore, PHARMD
• Adrienne L Moore
• Barbara Ann Moore, LMFT
• Bridgett Moore, M.D.
• Daphne Moore
• Hannah Moore, PMHNP-BC
• Joseph Moore, MSPT

• Physical Therapist in Valdosta, GA
• Providers in Valdosta, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.