Individual provider Active NPI

Sean Moran, D.C., M.S.

  • Chiropractor
  • Bryan, OH
National Provider Identifier
1154466860
Registry record updated Nov 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2976 Issued in OH
Practice address
1113 W High St
Bryan, OH 43506-1541
Phone
(419) 636-5279
Fax
(419) 636-5805
NPI assigned
Feb 20, 2007
Last updated
Nov 17, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2976 OH Primary

Addresses

Primary practice location

1113 W High St
Bryan, OH 43506-1541

Mailing address

1113 W High St
Bryan, OH 43506-1541
Phone (419) 636-5279

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190610001726 AZ Practitioner - Chiropractic 4082656319 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2976OHMDChiropractor
8782AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bennett Clinic LLC CurrentSince Apr 2, 2019 Accepting new patients
Bennett Clinic LLC CurrentSince Apr 2, 2019 Accepting new patients
Phoenix Chiropractic Injury Clinic, LLC Chiropractor Current Accepting new patients

Locations

1202 Willow Creek Rd
Prescott, AZ 86301
Phone (928) 771-9400

3191 Stillwater Dr
Ste B
Prescott, AZ 86305
Phone (928) 212-1479

7749 E Florentine Rd
Ste B
Prescott Vly, AZ 86314
Phone (928) 308-7161

Organizations & group practices 3

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": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479340800000",
    "number": "1154466860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1113 W HIGH ST",
            "city": "BRYAN",
            "state": "OH",
            "postal_code": "435061541",
            "telephone_number": "419-636-5279",
            "fax_number": "419-636-5805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1113 W HIGH ST",
            "city": "BRYAN",
            "state": "OH",
            "postal_code": "435061541",
            "telephone_number": "419-636-5279",
            "fax_number": "419-636-5805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAN",
        "first_name": "SEAN",
        "name_prefix": "Dr.",
        "credential": "D.C., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-20",
        "last_updated": "2016-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "2976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryan, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.