Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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John Wayne Moore, PA-C

Individual provider Medical Physician Assistant · NPI 1669552550

John Wayne Moore, PA-C is a Physician Assistant in Wasilla, Alaska. Qualified in 2001, 25 years ago. Practices with Spine and Sports Injury Center, LLC, a 4-clinician group and accepts Medicare assignment. Licensed in Alaska.

Years since qualifying
25
Licensed in
AK
In the registry since
2006
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1001 E Bogard Rd
Wasilla, AK 99654-7114
Phone: (907) 373-2225
Fax: (907) 376-9225
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 508 (AK)
Medical Physician Assistant Taxonomy 363AM0700X

Record details

NPI number1669552550
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 16, 2006
Last updated in NPPESJuly 1, 2024
Certification dateJuly 1, 2024
Mailing address1001 E Bogard Rd, Wasilla, AK 99654-7114

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2001 (25 years in practice)
Group practice Spine And Sports Injury Center, Llc — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Wasilla