Individual provider Active NPI

Andrew W Moore, DC

  • Chiropractor
  • San Antonio, TX
National Provider Identifier
1083725444
Registry record updated Sep 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4749DC Issued in TX
Practice address
8507 McCullough Ave
Ste a-1
San Antonio, TX 78216-6458
Phone
(210) 525-9063
Fax
(210) 308-0494
NPI assigned
Aug 31, 2006
Last updated
Sep 9, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4749DC TX Primary

Addresses

Primary practice location

8507 McCullough Ave
Ste a-1
San Antonio, TX 78216-6458

Mailing address

8507 McCullough Ave
Ste a-1
San Antonio, TX 78216-6458
Phone (210) 525-9063

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120911000334 TX Practitioner - Chiropractic 1557519824 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8507 McCullough
Suite a 1
San Antonio, TX 78216-6457

8507 McCullough Ave
A1
San Antonio, TX 78216-6457
Phone (210) 525-9063

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4749DCTXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Andrew W Moore DC PC Chiropractor CurrentSince Jun 3, 2012 Accepting new patients

Locations

8507 McCullough Ave
Ste A1
San Antonio, TX 78216
Phone (210) 525-9063

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283990400000",
    "number": "1083725444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8507 MCCULLOUGH AVE",
            "address_2": "STE A-1",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782166458",
            "telephone_number": "210-525-9063",
            "fax_number": "210-308-0494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8507 MCCULLOUGH AVE",
            "address_2": "STE A-1",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782166458",
            "telephone_number": "210-525-9063",
            "fax_number": "210-308-0494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ANDREW",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2010-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "4749DC",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.