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

Kaitlin Moore

Individual provider Physical Therapist · NPI 1790483667

Kaitlin Moore is a Physical Therapist in Private Practice in Enterprise, Alabama. Qualified in 2022, 4 years ago. Practices with Southern Spine and Sport, a 3-clinician group and accepts Medicare assignment. Licensed in Alabama.

Years since qualifying
4
Licensed in
AL
In the registry since
2023
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Practice location Address checks out

1109 Boll Weevil Cir Ste 2
Enterprise, AL 36330-1454
Phone: (334) 828-7591
Fax: (334) 828-7298
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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 PTH11229 (AL)

Record details

NPI number1790483667
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedFebruary 21, 2023
Last updated in NPPESFebruary 21, 2023
Certification dateFebruary 21, 2023
Mailing address1711 College Ave, Jackson, AL 36545-2425

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Southern Spine And Sport — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Enterprise