Individual provider Active NPI

Seth Garrett Moore

  • Chiropractor
  • Tahlequah, OK
National Provider Identifier
1154985091
Registry record updated Jan 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4322 Issued in OK
Practice address
401 E Downing St
Tahlequah, OK 74464-3015
Phone
(918) 734-2711
NPI assigned
Apr 25, 2019
Last updated
Jan 13, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4322 OK Primary

Addresses

Primary practice location

401 E Downing St
Tahlequah, OK 74464-3015

Mailing address

401 E Downing St
Tahlequah, OK 74464-3015
Phone (918) 734-2711

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190521003264 OK Practitioner - Chiropractic 1254674971 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1534 Echota Ave
Tahlequah, OK 74464-5801
Phone (918) 456-1300

401 E Downing St
Tahlequah, OK 74464-3015

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4322OKMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Health First Chiropractic Clinic PLLC Chiropractor CurrentSince May 1, 2019 Accepting new patients
Moore Imbibition LLC Chiropractor CurrentSince Feb 1, 2021 Accepting new patients
Anthony Ferrara Chiropractic PC Chiropractor PastSince Nov 8, 2009 Accepting new patients

Locations

60 NW Sheridan Rd
Ste 5
Lawton, OK 73505
Phone (580) 354-9009

1534 Echota Ave
Tahlequah, OK 74464
Phone (918) 456-1300

401 E Downing St
Tahlequah, OK 74464
Phone (918) 316-3764

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": "1556150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610496000000",
    "number": "1154985091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 E DOWNING ST",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744643015",
            "telephone_number": "918-734-2711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E DOWNING ST",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744643015",
            "telephone_number": "918-734-2711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "SETH",
        "middle_name": "GARRETT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-25",
        "last_updated": "2021-01-13",
        "certification_date": "2021-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "4322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tahlequah, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2021; 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.