ONDRELL MOORE – Physical Therapist, NPI 1306906532

ONDRELL MOORE is a healthcare provider. based in Jonesboro, Georgia. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold a License No. 007284 (GA). The NPI Number for ONDRELL MOORE is 1306906532

Main info

Male
29 Years Of Experience
Accepts Medicare Assignment
Name
ONDRELL MOORE
NPI
1306906532
Phone
(770) 631-8277
Address
PO BOX 518
Enumeration Date
11 December 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN SHREVEPORT
Secondary Phone
3182228892
Graduation Year
1997 (29 years ago)
PAC ID
3971016643
Group Practice PAC ID
9931275419
Professional Enrollment ID
I20250627000352
Address ID
LA711014748SH663XXSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

2,870 PHYSICAL THERAPIST IN PRIVATE PRACTICE in GA

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Provider Addresses for ONDRELL MOORE

  • PO BOX 518

    JONESBORO, GA 302370518

    Phone: (770) 631-8277

    Fax: (770) 631-9403

    Type: Mailing

  • Thornton Road, Lithia Springs, Douglas County, Georgia, 30122, United States

    LITHIA SPRINGS, GA 301222634

    Phone: (770) 739-3880

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-06-27

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250627000352IPhysical Therapist In Private PracticeLATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 30237)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9931275419View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeCT
Physical Therapist In Private PracticeLA
Physical Therapist In Private PracticeMD
Physical Therapist In Private PracticeLA
Physical Therapist In Private PracticeMS
Physical Therapist In Private PracticeLA
Physical Therapist In Private PracticeLA
-KY
Physical Therapist In Private PracticeLA
Physical Therapist In Private PracticeLA

Reviews

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Frequently asked questions

Does ONDRELL MOORE have a public NPI I can cite?
Public records show ONDRELL MOORE under NPI 1306906532.
Does the public listing show ONDRELL MOORE as active?
ONDRELL MOORE's NPI record reflects an active status in NPPES.
What does the directory say ONDRELL MOORE does?
Insurance directories may phrase it differently, but here ONDRELL MOORE maps to Physical Therapist. Clinical services aligned with this taxonomy classification.
Which community is linked to ONDRELL MOORE?
ONDRELL MOORE shows a connection to Jonesboro, Georgia in registry-derived data.
Who maintains ONDRELL MOORE's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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