Daniel Gerald Moore, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

003531 Issued in MN

Practice address

19332 Highway 169
Elk River, MN 55330-4645

Phone

(763) 441-7788

Fax

(763) 441-8818

NPI assigned

Aug 12, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Chiropractic

Education

Northwestern College of Chiropractic, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bodywise Chiropractic CenterGroup PAC ID 2264456433, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Bodywise Chiropractic Center

  • Chiropractor
  • Elk River, MN
  • NPI 1699809756
  Medicare reassignment Care Compare group NPD Authorized official
• Dockter - Lutz Chiropractic, LLC

  • Chiropractor
  • Circle Pines, MN
  • NPI 1093816258
  NPD (past)
• East St Paul Health PA

  • Chiropractor
  • Saint Paul, MN
  • NPI 1376967489
  NPD (past)

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

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552867200000",
    "number": "1285636845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19260 EVANS ST NW",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553301076",
            "telephone_number": "763-441-7788",
            "fax_number": "763-441-8818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19332 HIGHWAY 169",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553304645",
            "telephone_number": "763-441-7788",
            "fax_number": "763-441-8818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "DANIEL",
        "middle_name": "GERALD",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-12",
        "last_updated": "2019-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "003531",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "1990917",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "421027100",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "75B35MO",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mallory Casey Mitchell
• Modern Day Living
• Laura Jeanne Moe, OD
• Momentum Health and Wellness Minnesota, P.L.L.C.
• Michelle Monson, MD
• Jedediah Moore, D.C.
• Margaret Ann Moore
• Shae Alexandra Morsfield
• Elizabeth May Mosley, O.D.
• Teresa Movick-Anderson

• Chiropractor in Elk River, MN
• Providers in Elk River, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 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.