Organization Active NPI

Moore Chiropractic Family Center

  • Chiropractor
  • Danville, IL
National Provider Identifier
1063697662
Registry record updated Jan 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38003799 Issued in IL
Legal business name
MOORE CHIROPRACTIC FAMILY CENTER
Practice address
425 N Gilbert St
Danville, IL 61832-5633
Phone
(217) 443-2400
Fax
(217) 443-4199
NPI assigned
Jan 2, 2008
Last updated
Jan 2, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Terrance Wesley Moore, DC
Title
Chiropractor
Phone
(217) 443-2400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 38003799 IL Primary

Addresses

Primary practice location

425 N Gilbert St
Danville, IL 61832-5633

Mailing address

425 N Gilbert St
PO Box 495
Danville, IL 61832-5633
Phone (217) 443-2400

Other identifiers 2

IdentifierTypeStateIssuer
9215161OtherILBLUECROSSBLUESHIELD OF IL
38003799MedicaidIL

National Provider Directory

National Provider Directory

Locations

425 N Gilbert St
Danville, IL 61832
Phone (217) 443-2400

425 N Gilbert St
Ste C
Danville, IL 61832
Phone (217) 443-2400

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1199232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199232000000",
    "number": "1063697662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 N GILBERT ST",
            "address_2": "PO BOX 495",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618325633",
            "telephone_number": "217-443-2400",
            "fax_number": "217-443-4199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 N GILBERT ST",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618325633",
            "telephone_number": "217-443-2400",
            "fax_number": "217-443-4199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOORE CHIROPRACTIC FAMILY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-02",
        "last_updated": "2008-01-02",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "TERRANCE",
        "authorized_official_middle_name": "WESLEY",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "217-443-2400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "38003799",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSSBLUESHIELD OF IL",
            "identifier": "9215161",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38003799",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.