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

Michael Shane Moore, LPTA

Individual provider Physical Medicine & Rehabilitation Physician · NPI 1972115582

Michael Shane Moore, LPTA is a Physical Therapist in Private Practice in Montgomery, Alabama. Qualified in 2024, 2 years ago. Practices as a sole proprietor. Licensed in Alabama.

Years since qualifying
2
Licensed in
AL
In the registry since
2020
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Practice location Address checks out

2757 Vandy Ct
Montgomery, AL 36110-1339
Phone: (334) 669-1430
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Medicine & Rehabilitation Physician (primary) Taxonomy 208100000X · Licence PTA9712 (AL)

Record details

NPI number1972115582
Entity typeIndividual (Type 1)
GenderMale
Credentials LPTA
Sole proprietorYes
NPI enumeratedAugust 17, 2020
Last updated in NPPESAugust 17, 2020
Certification dateAugust 17, 2020
Mailing address2757 Vandy Ct, Montgomery, AL 36110-1339

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Accepts Medicare assignment Not indicated

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