Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jesse R Moore, LAT, ATC, LMT

Individual provider Athletic Trainer · NPI 1235600347

Jesse R Moore, LAT, ATC, LMT is an Athletic Trainer in Indianapolis, Indiana. Licensed in Indiana. Registered with an NPI since 2018.

Licensed in
IN
In the registry since
2018
What do these letters mean?
LAT — Licensed Athletic Trainer
A state-licensed athletic trainer.
ATC — Certified Athletic Trainer
Prevents and treats sport and activity injuries.
LMT — Licensed Massage Therapist
A state-licensed massage therapist.

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Practice location Address checks out

8111 S Emerson Ave
Indianapolis, IN 46237-8601
Phone: (317) 528-5000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence 36003079A (IN)

Record details

NPI number1235600347
Entity typeIndividual (Type 1)
GenderMale
Credentials LAT , ATC , LMT
Sole proprietorNo
NPI enumeratedDecember 16, 2018
Last updated in NPPESDecember 16, 2018

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