Organization Active NPI

Kent Moore Chiropractic, P.a.

  • Chiropractor
  • Rogers, AR
National Provider Identifier
1154526788
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1198 Issued in AR
Legal business name
KENT MOORE CHIROPRACTIC, P.A.
Practice address
2925 W Walnut St
Rogers, AR 72756-0338
Phone
(479) 636-6609
NPI assigned
Jun 14, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Jeffrey 'Kent' Moore, D.C.NPI 1922036433
Title
President
Phone
(479) 636-6609

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1198 AR Primary

Addresses

Primary practice location

2925 W Walnut St
Rogers, AR 72756-0338

Mailing address

2925 W Walnut St
Rogers, AR 72756-0338
Phone (479) 636-6609

Other names 1

  • Kent Moore Chiropractic Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130212000074 AR Part B Supplier - Clinic/Group Practice 1254585698 Receives reassigned benefits from 1 practitioner
Practice locations: Rogers, AR

National Provider Directory

National Provider Directory

Locations

2925 W Walnut St
Rogers, AR 72756
Phone (479) 636-6609

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1154526788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 W WALNUT ST",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727560338",
            "telephone_number": "479-636-6609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2925 W WALNUT ST",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727560338",
            "telephone_number": "479-636-6609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENT MOORE CHIROPRACTIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "'KENT'",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "479-636-6609",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AR",
            "license": "1198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kent Moore Chiropractic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Rogers, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.