Active NPI
John W. Moore, D.C.
- Chiropractor
- Muncie, IN
National Provider Identifier
1093835126
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 08001075
- Practice address
- 822 W White River Blvd
Muncie, IN 47303-3868 - Phone
- (765) 288-4769
- Fax
- (765) 284-8595
- NPI assigned
- Mar 30, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 08001075 | IN | Primary |
Addresses
Primary practice location
822 W White River Blvd
Muncie, IN 47303-3868
Mailing address
822 W White River Blvd
Muncie, IN 47303-3868
Phone (765) 288-4769
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100106680A | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070911000598 | IN | Practitioner - Chiropractic | 0143313890 | Practice locations: Muncie, IN |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - Davenport, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
822 W White River Blvd
Muncie, IN 47303-3868
Phone (765) 288-4769
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 08001075 | IN | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659312000000",
"number": "1093835126",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "822 W WHITE RIVER BLVD",
"city": "MUNCIE",
"state": "IN",
"postal_code": "473033868",
"telephone_number": "765-288-4769",
"fax_number": "765-284-8595"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "822 W WHITE RIVER BLVD",
"city": "MUNCIE",
"state": "IN",
"postal_code": "473033868",
"telephone_number": "765-288-4769",
"fax_number": "765-284-8595"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "JOHN",
"middle_name": "W.",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-30",
"last_updated": "2022-08-01",
"certification_date": "2022-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IN",
"license": "08001075",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100106680A",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Muncie, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2022; 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.