Individual provider Active NPI

Robert James Moore, D.C.

  • Chiropractor
  • Ft Oglethorpe, GA
National Provider Identifier
1245669290
Registry record updated Jul 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR009569 Issued in GA
Practice address
955 Battlefield Pkwy
Ft Oglethorpe, GA 30742-3945
Phone
(706) 866-7575
NPI assigned
Nov 9, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2721 TN
Chiropractor 111N00000X CHIR009569 GA Primary

Addresses

Primary practice location

955 Battlefield Pkwy
Ft Oglethorpe, GA 30742-3945

Mailing address

955 Battlefield Pkwy
Fort Oglethorpe, GA 30742-3945
Phone (706) 866-7575

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140107000919 TN Practitioner - Chiropractic 4183852668 Reassigns benefits to 1 organization
Practice locations: Cleveland, TN
I20201026001569 GA Practitioner - Chiropractic 4183852668 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

801 Chickamauga Ave
Rossville, GA 30741-1406
Phone (423) 653-6977

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIR009569GAMDChiropractor
2721TNMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Lookout Chiropractic, PLLC Chiropractor CurrentSince Jun 30, 2018 Accepting new patients
Back to Health Chiropractic, LLC Chiropractor CurrentSince Sep 1, 2020 Accepting new patients
Johnson Clinic of Chiropractic P.C. PastSince Jul 2, 2013 Accepting new patients
Cinderella Wigs Inc PastSince Sep 1, 2020 Accepting new patients
Cleveland Pain Management, PC Chiropractor Past Accepting new patients
Deroos Family & Pediatric Health Center PC Chiropractor Past Accepting new patients
Total Health PLLC Chiropractor PastSince Aug 29, 2018 Accepting new patients

Locations

801 Chickamauga Ave
Rossville, GA 30741
Phone (423) 653-6977

3536 Cummings Hwy
Ste 120
Chattanooga, TN 37419
Phone (423) 825-5252

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1383955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469404800000",
    "number": "1245669290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 BATTLEFIELD PKWY",
            "city": "FORT OGLETHORPE",
            "state": "GA",
            "postal_code": "307423945",
            "telephone_number": "706-866-7575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 BATTLEFIELD PKWY",
            "city": "FT OGLETHORPE",
            "state": "GA",
            "postal_code": "307423945",
            "telephone_number": "706-866-7575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ROBERT",
        "middle_name": "JAMES",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-11-09",
        "last_updated": "2016-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "2721",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR009569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft Oglethorpe, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2016; 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.