Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Cody D Moon, DPT/ATC

Individual provider Athletic Trainer · NPI 1790340693

Cody D Moon, DPT/ATC is a Physical Therapist in Private Practice in Little Rock, Arkansas. Qualified in 2025, 1 year ago. Practices with University of Arkansas for Medical Sciences, a 1,144-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
1
Licensed in
MO
In the registry since
2019
Specialties on file
2
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Practice location Address checks out

10815 Colonel Glenn Rd Ste 500
Little Rock, AR 72204-8041
Phone: (501) 406-9201
Fax: (501) 320-7813
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 4301 W Markham St # 500, Little Rock, AR 72205-7101 — (501) 686-8000

Specialties & licences

Orthopedic Physical Therapist (primary) Taxonomy 2251X0800X
Athletic Trainer Taxonomy 2255A2300X · Licence 2018016971 (MO)

Record details

NPI number1790340693
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT/ATC
Sole proprietorNo
NPI enumeratedMay 6, 2019
Last updated in NPPESAugust 14, 2025
Certification dateAugust 6, 2025
Mailing address4301 W Markham St # 783, Little Rock, AR 72205-7101

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice University Of Arkansas For Medical Sciences — 1144 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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