Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

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

Q: 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.

Q: What is Addison Moore's specialty?

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

Q: 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 30 days 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.

Active since March 28, 2022PECOS Enrolled

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: August 02, 2026.

On this page

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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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Addison Moore is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6103208509

PECOS Enrollment IDI20260406001663

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.

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