SHANNON MOORE (NPI# 1033764055) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033764055 |
| Entity Type | Individual |
| Full Name | SHANNON MOORE |
| Credential | DPT |
| Practice Address |
235 Open Sky Way Kila MT 59920-7700 |
| Mailing Address |
Po Box 752 Kila MT 59920-0752 |
| Practice Telephone | 6785548088 |
| Enumeration Date | 2019-08-06 |
| Last Update Date | 2019-08-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251X0800X |
Physical Therapist Specialization: Orthopedic |
PT013525 | GA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043825565 | Shannon Roberta Moore | In Home Supportive Care | 5686 Broadview Rd Apt 2520, Parma, OH 44134-1647 | 2020-09-11 |
| 1770006660 | Shannon Moore | Optometrist | 340 Wood Rd Ste 2020, Braintree, MA 02184-2404 | 2017-07-21 |
| 1316327851 | Shannon Moore | Technician, Other | 24837 Princeton St, Dearborn, MI 48124-4457 | 2015-05-30 |
| 1659713071 | Shannon Lori Moore | Dietitian, Registered | 1114 Thomasville Rd Ste G, Tallahassee, FL 32303-6273 | 2013-07-26 |
| 1326388893 | Shannon Michelle Moore | Developmental Therapist | 340 Ralley Rd, Keavy, KY 40737-2729 | 2013-02-21 |
| 1639414345 | Shannon L Moore | Licensed Practical Nurse | 1235 3rd Street, Sedro-woolley, WA 98284 | 2012-12-06 |
| 1669767208 | Shannon M Moore | Pharmacist | 80 Baker St, Richmond, VT 05477-7750 | 2011-06-11 |
| 1154636611 | Shannon Monique Moore | Psychologist | 1675 Lakeland Dr Ste 304, Jackson, MS 39216 | 2010-08-09 |
| 1689630246 | Shannon Jessica Moore | Optometrist | 528 Waterloo Rd, Warrenton, VA 20186-3011 | 2006-04-24 |
| 1144863176 | Shannon Moore | Behavior Technician | 901 O St, Suite C, Arcata, CA 95521-5789 | 2019-10-22 |
| Street Address |
235 OPEN SKY WAY |
| City | KILA |
| State | MT |
| Zip Code | 59920-7700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417908567 | Kathleen Mae Ingalls | Physical Therapist | 4220 Highway 2 West, Kila, MT 59920 | 2006-05-13 |
| 1639323645 | Mindful Motion Physical Therapy and Wellness, Inc. | Clinic/Center | 4220 Highway 2 West, Kila, MT 59920-9728 | 2008-11-05 |
| 1831638337 | Kila School District #20 | Local Education Agency (LEA) | 395 Kila Rd, Kila, MT 59920-9741 | 2017-02-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831638337 | Kila School District #20 | Local Education Agency (LEA) | 395 Kila Rd, Kila, MT 59920-9741 | 2017-02-16 |
| 1417908567 | Kathleen Mae Ingalls | Physical Therapist | 4220 Highway 2 West, Kila, MT 59920 | 2006-05-13 |
| 1639323645 | Mindful Motion Physical Therapy and Wellness, Inc. | Clinic/Center | 4220 Highway 2 West, Kila, MT 59920-9728 | 2008-11-05 |
| Taxonomy Code | 2251X0800X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Orthopedic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487265302 | Kelli Wrolstad | Physical Therapist | 129 Skaggs Building, Missoula, MT 59812-0001 | 2020-08-13 |
| 1346886405 | Helena Spine and Joint Rehab | Physical Therapist | 2956 Aspenway Dr, Helena, MT 59601-6601 | 2019-11-25 |
| 1912253204 | Nicole Lynn Feliksa | Physical Therapist | 23 Lyla Ln, Plains, MT 59859-9204 | 2012-07-24 |
| 1578822821 | Fred Lerch | Physical Therapist | 117 Apple House Ln, Ste 501, Missoula, MT 59802-3324 | 2012-05-07 |
| 1013183110 | Timothy G Redfern | Physical Therapist | 472 Tammany Lane, Hamilton, MT 59840-9216 | 2008-05-08 |
| 1790981165 | Miri Allyn Disney-faller | Physical Therapist | 2244 South Ave W, Missoula, MT 59801-6502 | 2007-06-22 |
| 1740499458 | Patricia Marie Mangan | Physical Therapist | 3055 N Reserve St Ste D, Missoula, MT 59808 | 2007-05-21 |
| 1245448828 | Elizabeth R Ikeda | Physical Therapist | 3036 Queen St, Missoula, MT 59801-8651 | 2007-05-18 |
| 1205056132 | Irina Shuck | Physical Therapist | 5014 Maple Ridge Cir, Billings, MT 59106-4429 | 2007-04-25 |
| 1952457962 | Dennis P. Rau | Physical Therapist | 2625 E Broadway St, Helena, MT 59601-4912 | 2007-01-25 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.