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

Jesse Moore, DPT, MBA

Individual provider Physical Therapist · NPI 1043555410

Jesse Moore, DPT, MBA is a Physical Therapist in Private Practice in Glen Carbon, Illinois. Qualified in 2007, 19 years ago. Practices with Ap Therapy LLC, a 58-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
19
Licensed in
IL
In the registry since
2012
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.
MBA — Master of Business Administration
A graduate business degree.

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Practice location Address checks out

3008 Huntsville Dr
Glen Carbon, IL 62034-3046
Phone: (317) 691-6262
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 070018656 (IL)

Record details

NPI number1043555410
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT , MBA
Sole proprietorNo
NPI enumeratedDecember 11, 2012
Last updated in NPPESDecember 11, 2012
Mailing address3008 Huntsville Dr, Glen Carbon, IL 62034-3046

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2007 (19 years in practice)
Group practice Ap Therapy Llc — 58 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Glen Carbon