Individual provider Active NPI

John Richard Moore, D.C.

  • Chiropractor
  • Ames, IA
National Provider Identifier
1144210212
Registry record updated Apr 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
A5288 Issued in IA
Practice address
809 Wheeler St Ste 2
Ames, IA 50010-4367
Phone
(515) 233-1709
Fax
(515) 232-1917
NPI assigned
Oct 28, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 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 A5288 IA Primary

Addresses

Primary practice location

809 Wheeler St Ste 2
Ames, IA 50010-4367

Mailing address

809 Wheeler St Ste 2
Ames, IA 50010-4367
Phone (515) 233-1709

Other identifiers 5

IdentifierTypeStateIssuer
42678OtherIABCBS
1346383619OtherIAGROUP NPI
1144210212OtherIAINDIVIDUAL NPI
IA 17029MedicaidIA
0087973MedicaidIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050420000570 IA Practitioner - Chiropractic 7315985371 Reassigns benefits to 1 organization

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)

809 Wheeler St
Ames, IA 50010-4472
Phone (515) 233-1709

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A5288IAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Cyclone Healthcare Inc. Chiropractor CurrentSince Jul 1, 1996 Accepting new patients

Locations

809 Wheeler St
Ste 104
Ames, IA 50010
Phone (515) 233-1709

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1130457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270512000000",
    "number": "1144210212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 WHEELER ST STE 2",
            "city": "AMES",
            "state": "IA",
            "postal_code": "500104367",
            "telephone_number": "515-233-1709",
            "fax_number": "515-232-1917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 WHEELER ST STE 2",
            "city": "AMES",
            "state": "IA",
            "postal_code": "500104367",
            "telephone_number": "515-233-1709",
            "fax_number": "515-232-1917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JOHN",
        "middle_name": "RICHARD",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-28",
        "last_updated": "2010-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "A5288",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "42678",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1346383619",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1144210212",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "IA 17029",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0087973",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ames, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 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.