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

Kevin Emmanual Moore, DPM

Individual provider Foot & Ankle Surgery Podiatrist · NPI 1104111590

Kevin Emmanual Moore, DPM is a Podiatry in Warner Robins, Georgia. Graduated from Barry University School of Podiatric Medicine in 2008, 18 years ago. Practices with Georgialina Physical Therapy Associates LLC, a 429-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Georgia and Oklahoma.

Years since qualifying
18
Trained at
Barry University School of Podiatric Medicine
Licensed in
GA, OK
In the registry since
2011
Specialties on file
2
What do these letters mean?
DPM — Doctor of Podiatric Medicine
A foot and ankle physician and surgeon.

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Practice location Address checks out

109 Osigian Blvd Ste 300
Warner Robins, GA 31088-8924
Phone: (478) 333-2430
Fax: (478) 333-2173
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 4116 Arkwright Rd Ste 1, Macon, GA 31210-1707 — (478) 333-2430

Specialties & licences

Foot & Ankle Surgery Podiatrist (primary) Taxonomy 213ES0103X · Licence POD001181 (GA)
Foot & Ankle Surgery Podiatrist Taxonomy 213ES0103X · Licence 288 (OK)

Record details

NPI number1104111590
Entity typeIndividual (Type 1)
GenderMale
Credentials DPM
Sole proprietorYes
NPI enumeratedJune 14, 2011
Last updated in NPPESFebruary 1, 2022
Certification dateFebruary 1, 2022

Medicare enrollment

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

Medicare specialtyPODIATRY
Medical schoolBARRY UNIVERSITY SCHOOL OF PODIATRIC MEDICINE
Graduated 2008 (18 years in practice)
Group practice Georgialina Physical Therapy Associates Llc — 429 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Warner Robins