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ADDISON MOORE
NPI 1205586583
Family Medicine - Sports Medicine in Northport, AL

Active since March 28, 2022PECOS EnrolledAccepts Medicare Assignment
4310 WATERMELON RD, NORTHPORT, AL 35473(205) 330-5266(205) 330-9915 Get Directions Write a Review

NPPES record last updated: July 9, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Addison Moore NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ADDISON MOORE (NPI 1205586583) is an individual sports medicine provider in Northport, Alabama, licensed in Alabama (DO.3765) and active in the NPI registry since March 2022. He is enrolled in Medicare PECOS and is a graduate of Edward Via Col Of Osteo Medicine-virginia Campus (2022).

NPPES Registry Identity

NPI1205586583
Entity TypeIndividualMale
Primary Taxonomy207QS0010X
Provider Legal NameADDISON MOORE
Location Address4310 WATERMELON RDNorthport, AL 35473-5166
Mailing Address4310 Watermelon RdNorthport, AL 35473-5166 · (205) 710-6129 · Fax (205) 710-2116
Phone(205) 330-5266
Fax(205) 330-9915
Sole ProprietorNo
Medical School CMSEdward Via Col Of Osteo Medicine-virginia CampusGraduated 2022
Enumeration DateMarch 28, 2022
Last NPPES UpdateJuly 9, 2026
NPPES CertifiedJuly 9, 2026
✔ NPI 1205586583 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Sports MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QS0010X
License✔ Licensed in AL · DO.3765
Definition
A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation.
4310 WATERMELON RD, Northport, AL 35473
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Alabama.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Addison Moore is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6103208509
PECOS Enrollment IDI20260625001839
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Addison Moore reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Slcm LLC
Same address
Family Medicine
4310 WATERMELON RD
Northport, AL 35473
  • Reassigned Medicare billing, Alabama enrollment
  • 10 clinicians in this Medicare group
NPI 1336474964 (205) 330-5266

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 35473 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$81.90 typical visit price
range $52.65 – $161.63
Typical copayment $20.47 (range $13.16 – $40.40)
Most-billed visit code 99203
Established Patient
$93.72 typical visit price
range $16.56 – $131.65
Typical copayment $23.43 (range $4.14 – $32.91)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RONALD HARRISON DO
Family Medicine
4310 WATERMELON RD
NORTHPORT, AL 35473
Tuscaloosa County (205) 330-5266
ERICA COLLEY NP
Nurse Practitioner (Family)
4310 WATERMELON RD
NORTHPORT, AL 35473
Tuscaloosa County (205) 614-6004
AMY MCCOOL WYATT CRNP
Nurse Practitioner
4310 WATERMELON RD
NORTHPORT, AL 35473
Tuscaloosa County (205) 330-5266
SLCM LLC
Family Medicine
4310 WATERMELON RD
NORTHPORT, AL 35473
Tuscaloosa County (205) 330-5266
CLINTON ERLE MCENTYRE M.D.
Family Medicine
4310 WATERMELON RD
NORTHPORT, AL 35473
Tuscaloosa County (205) 330-5266
MARY JORDAN CONWAY ARMSTRONG
Nurse Practitioner (Family)
4310 WATERMELON RD
NORTHPORT, AL 35473
Tuscaloosa County (205) 330-5266
CAROLINE JORDAN RAINEY CRNP
Nurse Practitioner (Family)
4310 WATERMELON RD
NORTHPORT, AL 35473
Tuscaloosa County (205) 330-5266
SCOTT W KEMP D.O.
Family Medicine
4310 WATERMELON RD
NORTHPORT, AL 35473
Tuscaloosa County (205) 330-5266

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Addison Moore's NPI number?

The NPI number for Addison Moore is 1205586583. It was assigned to this individual provider in the NPPES registry on March 28, 2022.

Where is Addison Moore located?

Addison Moore practices at 4310 Watermelon Rd, Northport, AL 35473. The listed phone number is (205) 330-5266.

What is Addison Moore's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Sports Medicine, with taxonomy code 207QS0010X.

Is Addison Moore enrolled in Medicare?

Yes. Addison Moore is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Addison Moore's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Addison Moore reassigns Medicare benefits to Slcm LLC (Northport, AL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Addison Moore's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Addison Moore accept?

Health plans from Blue Cross and Blue Shield of Alabama list Addison Moore as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Addison Moore was last updated on July 9, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.