Individual provider Active NPI

Michael Joshua Moorhouse, D.C.

  • Chiropractor
  • Meridian, ID
National Provider Identifier
1104855691
Registry record updated Feb 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIA-1109 Issued in ID
Practice address
4660 N Penngrove Way Ste 110
Meridian, ID 83646-8042
Phone
(208) 938-2992
Fax
(208) 938-3476
NPI assigned
Jun 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIA-1109 ID Primary

Addresses

Primary practice location

4660 N Penngrove Way Ste 110
Meridian, ID 83646-8042

Mailing address

4660 N Penngrove Way Ste 110
Meridian, ID 83646-8042
Phone (208) 938-2992

Other identifiers 2

IdentifierTypeStateIssuer
00010149230OtherIDBLUE SHEILD
C4389OtherIDBLUE CROSS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050217000952 ID Practitioner - Chiropractic 9830141837 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Western States College of Chiropractic, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4660 N Penngrove Way
Suite 110
Meridian, ID 83646-8042
Phone (208) 938-2992

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIA-1109IDMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Michael J. Moorhouse Inc. CurrentSince Jul 15, 2019 Accepting new patients
Delray Maughan, M.D. PLLC PastSince Jun 21, 2017 Accepting new patients

Locations

4660 N Penngrove Way
Ste 110
Meridian, ID 83646
Phone (208) 938-2992

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645488000000",
    "number": "1104855691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4660 N PENNGROVE WAY STE 110",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836468042",
            "telephone_number": "208-938-2992",
            "fax_number": "208-938-3476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4660 N PENNGROVE WAY STE 110",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836468042",
            "telephone_number": "208-938-2992",
            "fax_number": "208-938-3476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORHOUSE",
        "first_name": "MICHAEL",
        "middle_name": "JOSHUA",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2022-02-22",
        "certification_date": "2022-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-1109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHEILD",
            "identifier": "00010149230",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "C4389",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 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.

Verify at the official NPI Registry.