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

Michael Ryan Moore, DPT

Individual provider Physical Therapist · NPI 1033422902

Michael Ryan Moore, DPT is a Physical Therapist in Private Practice in Charleston, South Carolina. Qualified in 2010, 16 years ago. Practices with Agilitas USA, Inc, a 810-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in South Carolina and Virginia.

Years since qualifying
16
Licensed in
SC, VA
In the registry since
2010
Specialties on file
2
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

628TH Medical Group 204 West Hill Blvd
Charleston, SC 29404
Phone: (804) 571-5000
Fax: (804) 518-1314
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 5401 Netherby Ln Ste 302, North Charleston, SC 29420-7363 — (843) 225-5211
  • 131 Jennick Dr, Colonial Heights, VA 23834-4905 — (804) 526-5888

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 8765 (SC)
Physical Therapist Taxonomy 225100000X · Licence 2305206565 (VA)

Record details

NPI number1033422902
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT
Sole proprietorNo
NPI enumeratedJuly 21, 2010
Last updated in NPPESDecember 10, 2025
Certification dateDecember 10, 2025

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2010 (16 years in practice)
Group practice Agilitas Usa, Inc — 810 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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