Shawn Moore (NPI# 1912350158, PAC ID# 2365776309) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICAL THERAPY.
| Nation Provider ID (NPI) | 1912350158 |
| PAC ID by PECOS | 2365776309 |
| Professional Enrollment ID | I20190626000631 |
| Full Name | Shawn Moore |
| Organization Legal Name | NORTHEAST KINGDOM PHYSICAL THERAPY, PC |
| Address |
62 Cross St Island Pond VT 05846 |
| Phone Number | 8027239817 |
| Gender | M |
| Graduation Year | 2016 |
| Primary Specialty | PHYSICAL THERAPY |
| Group Practice PAC ID | 1759324023 |
| Number of Group Practice Members | 3 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 62 Cross St, Island Pond, VT 05846 | 8027239817 | NORTHEAST KINGDOM PHYSICAL THERAPY, PC |
| Organization Legal Name | NORTHEAST KINGDOM PHYSICAL THERAPY, PC |
| Physicians | 3 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| William L Hogan | Physical Therapy | Northeast Kingdom Physical Therapy, PC | 76 Lakemont Rd, Newport, VT 05855-9690 |
| Anthony J Tomaselli | Physical Therapy | Northeast Kingdom Physical Therapy, PC | 62 Cross St, Island Pond, VT 05846 |
| Street Address |
62 CROSS ST |
| City | ISLAND POND |
| State | VT |
| Zip | 05846 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Anthony J Tomaselli | Physical Therapy | Northeast Kingdom Physical Therapy, PC | 62 Cross St, Island Pond, VT 05846 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mandy L Poginy | Nurse Practitioner | Northern Counties Health Care, Inc. | 82 Maple St, Island Pond, VT 05846 |
| Tina K Heck | Nurse Practitioner | Northern Counties Health Care, Inc. | 82 Maple St, Island Pond, VT 05846 |
| Robert E Primeau | Internal Medicine | Northern Counties Health Care, Inc. | 82 Maple St, Island Pond, VT 05846 |
| City | ISLAND POND |
| Zip Code | 05846 |
| Specialty | PHYSICAL THERAPY |
| City + Specialty | ISLAND POND + PHYSICAL THERAPY |
Please comment or provide details below to improve the information on Shawn Moore.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.