Brian Keith Moore, MS, ATC
Specialist/Technologist, Athletic Trainer in Pittsburgh, PA. Individual provider (NPI-1).
NPI number1790749539
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1790749539
- Entity type
- Individual (NPI-1)
- Name
- Mr. Brian Keith Moore
- Credential
- MS, ATC
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 17, 2006
- Last updated
- Jul 8, 2007
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | RT000803A | PA | Yes |
Practice location
4653 Clairton BlvdPittsburgh, PA 15236-2149
Phone 412-885-7515 · Fax 412-885-6652
Mailing address
1552 Cathell RdPittsburgh, PA 15236-1110
Phone 412-668-0481
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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