Organization Active NPI

Moss Chiropractic Clinic LLC

  • Chiropractor
  • Palm Beach Gardens, FL
National Provider Identifier
1194058321
Registry record updated Sep 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH9024 Issued in FL
Legal business name
MOSS CHIROPRACTIC CLINIC LLC
Practice address
4361 Northlake Blvd
Palm Beach Gardens, FL 33410-6253
Phone
(561) 627-7771
Fax
(561) 627-5948
NPI assigned
Sep 4, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2009

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

Authorized official

Name
Dr. Damon T Moss, DCNPI 1184783300
Title
President
Phone
(561) 627-2287

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CH9024 FL Primary

Addresses

Primary practice location

4361 Northlake Blvd
Palm Beach Gardens, FL 33410-6253

Mailing address

4361 Northlake Blvd
Palm Beach Gardens, FL 33410-6253
Phone (561) 627-7771

Other identifiers 1

IdentifierTypeStateIssuer
8584749OtherFLCIGNA HEALTHCARE

Other names 1

  • Damon T Moss, DC Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091116000548 FL Part B Supplier - Clinic/Group Practice 5496893281 Receives reassigned benefits from 1 practitioner
Practice locations: Palm Beach Gardens, FL

National Provider Directory

National Provider Directory

Locations

4361 Northlake Blvd
Palm Beach Gardens, FL 33410
Phone (561) 627-7771

1580 SE Port St Lucie Blvd
Port St Lucie, FL 34952
Phone (561) 627-7771

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1252022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252022400000",
    "number": "1194058321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4361 NORTHLAKE BLVD",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334106253",
            "telephone_number": "561-627-7771",
            "fax_number": "561-627-5948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4361 NORTHLAKE BLVD",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334106253",
            "telephone_number": "561-627-7771",
            "fax_number": "561-627-5948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOSS CHIROPRACTIC CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-04",
        "last_updated": "2009-09-04",
        "status": "A",
        "authorized_official_last_name": "MOSS",
        "authorized_official_first_name": "DAMON",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-627-2287",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH9024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTHCARE",
            "identifier": "8584749",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Damon T Moss, DC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Palm Beach Gardens, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2009; 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.