Individual provider Active NPI

Dayna Moore, D.C

  • Sports Physician Chiropractor
  • Atlanta, GA
National Provider Identifier
1174862122
Registry record updated Sep 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
CHIR009103 Issued in GA
Practice address
3915 Cascade Rd SW
Atlanta, GA 30331-8512
Phone
(404) 699-0966
NPI assigned
Feb 12, 2013
Last updated
Sep 9, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2015

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR009103 GA
Nutrition Chiropractor 111NN1001X CHIR009103 GA
Sports Physician Chiropractor 111NS0005X CHIR009103 GA Primary
Rehabilitation Chiropractor 111NR0400X CHIR009103 GA

Addresses

Primary practice location

3915 Cascade Rd SW
Atlanta, GA 30331-8512

Mailing address

4982 Covington Hwy
Decatur, GA 30035-2017
Phone (404) 288-8433

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160317000751 GA Practitioner - Chiropractic 4789992868 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

777 Cleveland Ave SW
Suite 309
Atlanta, GA 30315-7118
Phone (678) 871-6437

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIR009103GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Vitality Rehab & Wellness Centers Rehabilitation CurrentSince Oct 15, 2020 Accepting new patients

Locations

777 Cleveland Ave SW
Ste 309
Atlanta, GA 30315
Phone (404) 734-6122

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, 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": "1360627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441756800000",
    "number": "1174862122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4982 COVINGTON HWY",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300352017",
            "telephone_number": "404-288-8433",
            "fax_number": "404-288-8430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3915 CASCADE RD SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303318512",
            "telephone_number": "404-699-0966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "DAYNA",
        "credential": "D.C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-12",
        "last_updated": "2015-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR009103",
            "primary": false
        },
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "GA",
            "license": "CHIR009103",
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "GA",
            "license": "CHIR009103",
            "primary": true
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "GA",
            "license": "CHIR009103",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2015; 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.