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Deactivated NPI 1851314009 Deactivated / Inactive NPI Male Practitioner

Roderick Gardner Moore , ATC LAT

Specialist/Technologist - Athletic Trainer • Valparaiso, IN

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Roderick Moore has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date July 26, 2006
NPI Deactivation Date August 19, 2020
Total Practice Duration ~14 Years of Practice (2006 – 2020)

Professional Overview & Biography Verified Profile Summary

Roderick Moore, ATC LAT was a registered Specialist/Technologist - Athletic Trainer practicing in Valparaiso, IN. Throughout an active medical career spanning 14 years, Roderick Moore provided care at the practice location at 1009 UNION STREET until profile deactivation on 2020-08-19.

Practice Location & Contact Primary Location

Practice Address

1009 Union Street

Valparaiso, IN 463836493

Telephone 2194645236
Fax 2194646897

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist/Technologist - Athletic Trainer in Valparaiso, IN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 9.0 Yrs
Regional Practice Density
13 Specialists

Practicing in Valparaiso, IN (1604 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Specialist/Technologist - Athletic Trainer Primary Specialty

NUCC Taxonomy Code: 2255A2300X

State License IN 36000263A

Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor's degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners
Susan Hayes , ATC

Specialist/Technologist - Athletic Trainer

NPI 1639295199

Certified Athletic Trainer

Rebekah Reichard , ATC

Specialist/Technologist - Athletic Trainer

NPI 1750780334

Certified Athletic Trainer

Andrew Ure , ATC

Specialist/Technologist - Athletic Trainer

NPI 1831525419

Certified Athletic Trainer

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated August 19, 2020

Record deactivated on August 19, 2020

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 1009 UNION STREET, VALPARAISO, IN 463836493 (Tel: 2194645236)

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Updated Business Mailing Address July 08, 2007

Registered at 1009 UNION STREET, VALPARAISO, IN 463836493 (Tel: 2194645236)

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Provider Name / Credentials Updated July 08, 2007

Recorded as RODERICK MOORE, ATC LAT

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Specialist/Technologist (License #36000263A in IN)

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Initial NPI Registration & Enumeration July 26, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1851314009
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 26, 2006
Last Update: July 08, 2007
Deactivation Date: August 19, 2020

Mailing Address

1009 Union Street

Valparaiso, IN 463836493

Phone: 2194645236

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.