NPI age
14 years
Enumerated 2011-06-14
● Active
Type 1 · Individual
Kevin Emmanual Moore, D.P.M.
Moore is 1 of 2 podiatrist providers in Warner Robins and 1 of 397 in Georgia.
Primary specialty
Podiatrist
Plus 1 subspecialty
Licensed in
GA, OK
2 states
Status
Active
No deactivations on record
Last NPPES update
2022-02-01
Source: monthly bulk 2026-05
Sole proprietor
Yes
Solo practice on file
How this provider compares
Across 397 active podiatrist providers in Georgia.
NPI age
14 years
≈ at median (15 yr)
State licenses
2 states
Top 86% — 13% of peers are multi-state
Subspecialties
0
25% of peers hold subspecialties
NPI lifetime · 2011 → 2026
2011-06Enumerated in NPPES
2011
2026
Where they practice
Practice location
109 Osigian Blvd Ste 300
Warner Robins, GA 310888924
Mailing address
Po Box 6619
MacOn, GA 312086619
Additional practice locations
1 secondary location on file with NPPES.
Location 2
4116 Arkwright Rd Ste 1
MacOn, GA 312101707
Specialties
-
Podiatrist PrimaryDefinition to come...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 003116370B |
Multi-state credentialing: Licensed in 2 states. Useful context for credentialers building cross-state provider networks.
Practice context
Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.
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