Individual provider Active NPI

Moriah Phillips, DC

  • Chiropractor
  • Saint Joseph, MO
National Provider Identifier
1285164095
Registry record updated Jul 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2017003300 Issued in MO
Practice address
3949 Sherman Ave
Saint Joseph, MO 64506-3649
Phone
(816) 987-8994
NPI assigned
Jun 14, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2017003300 MO Primary

Addresses

Primary practice location

3949 Sherman Ave
Saint Joseph, MO 64506-3649

Mailing address

4210 Bennington Dr
Saint Joseph, MO 64506-5074

Other names 1

  • Moriah Guldan Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190827001885 MO Practitioner - Chiropractic 8729316849 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Kansas City, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Green Family Chiropractic PCGroup PAC ID 5991988107, 2 clinicians

Practice addresses (Care Compare)

3949 Sherman Ave
Saint Joseph, MO 64506-3649
Phone (816) 387-8994

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2017003300MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Green Family Chiropractic PC Chiropractor CurrentSince Sep 3, 2019 Accepting new patients

Locations

3949 Sherman Ave
Saint Joseph, MO 64506
Phone (816) 279-4882

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1497398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563321600000",
    "number": "1285164095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4210 BENNINGTON DR",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645065074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3949 SHERMAN AVE",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645063649",
            "telephone_number": "816-987-8994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "MORIAH",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-14",
        "last_updated": "2019-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2017003300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MORIAH",
            "last_name": "GULDAN",
            "credential": "DC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Joseph, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2019; 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.