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Kaitlyn Moore

Physical Therapy Assistant β€’ Ravenna, OH

Active NPI 1679939698 Individual Practitioner Female Practitioner
Practice location in NPPES

6831 N Chestnut St
Ravenna, OH 442663929

Call 3302974564 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

6831 N Chestnut St

Ravenna, OH 442663929

Telephone 3302974564
Organization at the Same NPPES Address or Phone
Portage County Auditor Facility NPI 1619017399

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2016

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians, CMS release of October 2, 2026; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians, CMS release of October 2, 2026.

Guide: How Medicare covers telehealth

Compared with the same specialty in Ravenna and Ohio

11 active clinicians are listed under Physical Therapy Assistant with a practice address in Ravenna, OH (2,971 in Ohio).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Ravenna

0% of these 11 clinicians have the CMS telehealth indicator.

0% of these 11 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS release of October 2, 2026, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2021-03-24
Physical Therapy Assistant Primary Specialty

NUCC Taxonomy Code: 225200000X

License # reported to NPPES OH PTA011221

(1)Physical therapist assistants are skilled health care providers who are graduates of a physical therapist assistant associate degree program accredited by an agency recognized by the Secretary of the U.S. Department of Education or Council on Postsecondary Accreditation, who assists the physical therapist in providing physical therapy. The supervising physical therapist is directly responsible for the actions of the physical therapist assistant. The PTA performs physical therapy procedures and related tasks that have been selected and delegated by the supervising physical therapist. Duties of the PTA include assisting the physical therapist in implementing treatment programs, training patients in exercised and activities of daily living, conducting treatments, and reporting to the physical therapist on the patient's responses. In addition to direct patient care, the PTA may also perform such functions as patient transport, and clinic or equipment preparation and maintenance. Currently more than half of all states require PTAs to be licensed, registered or certified. (2) An individual who works under the supervision of a physical therapist to assist him or her in providing physical therapy services. A physical therapy assistant may, for instance, help patients follow an appropriate exercise program that will increase their strength, endurance, coordination, and range of motion and train patients to perform activities of daily life.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: State Medical Board of Ohio.
Look Up on State Board Site

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

10 Historical Events
πŸ“
Updated Practice Location March 24, 2021

Registered at 6831 N CHESTNUT ST, RAVENNA, OH 442663929 (Tel: 3302974564)

πŸ“
Updated Business Mailing Address March 24, 2021

Registered at 4843 KELLY AVE, ROOTSTOWN, OH 442729286 (Tel: 7247149348)

πŸ‘€
Provider Name / Credentials Updated March 24, 2021

Recorded as KAITLYN MOORE

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) March 24, 2021

Physical Therapy Assistant (license number reported to NPPES: OH PTA011221)

βœ…
NPI Profile Active January 06, 2016

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) January 06, 2016

Registered at 1400 E SOUTHERN AVE, SUITE 310, TEMPE, AZ 852825691 (Tel: 6025679881)

πŸ“
Business Mailing Address (Initial Record) January 06, 2016

Registered at 1400 E SOUTHERN AVE, SUITE 310, TEMPE, AZ 852825691

πŸ‘€
Provider Name / Credentials (Initial Record) January 06, 2016

Recorded as KAITLYN SHIDERLY

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) January 06, 2016

Physical Therapy Assistant (license number reported to NPPES: AZ 11853A)

🟒
Initial NPI Registration & Enumeration January 06, 2016

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1679939698
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 06, 2016
Last Update: March 24, 2021
Sole Proprietor: Yes

Mailing Address

4843 Kelly Ave

Rootstown, OH 442729286

Phone: 7247149348

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.