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

Ricquavious Moore, DPT

Individual provider Behavior Technician · NPI 1629736665

Ricquavious Moore, DPT is a Physical Therapist in Private Practice in Tucker, Georgia. Qualified in 2025, 1 year ago. Works from 2 locations. Licensed in Georgia.

Years since qualifying
1
Licensed in
GA
In the registry since
2021
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

1459 Montreal Rd Ste 304
Tucker, GA 30084-6920
Phone: (706) 832-8400
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1110 13th St, Columbus, GA 31901-2246 — (706) 221-7139

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT018125 (GA)
Behavior Technician Taxonomy 106S00000X

Record details

NPI number1629736665
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT
Sole proprietorNo
NPI enumeratedDecember 7, 2021
Last updated in NPPESDecember 12, 2025
Certification dateDecember 12, 2025
Mailing address1459 Montreal Rd Ste 304, Tucker, GA 30084-6920

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated

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