Individual provider Active NPI

Roy Alan Moore Jr., D.C.

  • Chiropractor
  • Windham, ME
National Provider Identifier
1295066256
Registry record updated Jan 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
PENDING Issued in ME
Practice address
936 Roosevelt TRL
Windham, ME 04062-5652
Phone
(207) 892-8356
Fax
(207) 892-1644
NPI assigned
Jan 14, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X PENDING ME Primary

Addresses

Primary practice location

936 Roosevelt TRL
Windham, ME 04062-5652

Mailing address

936 Roosevelt TRL
Windham, ME 04062-5652
Phone (207) 892-8356

Other names 1

  • Dr. R Alan Moore Jr. Professional name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100714000361 ME Practitioner - Chiropractic 4587796370 Practice locations: Windham, ME

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

936 Roosevelt TRL
Windham, ME 04062-5652
Phone (207) 892-8356

992 PO Box
Windham, ME 04062

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PENDINGMEMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Moore Chiropractic Center Past Accepting new patients

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": "1263427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263427200000",
    "number": "1295066256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "936 ROOSEVELT TRL",
            "city": "WINDHAM",
            "state": "ME",
            "postal_code": "040625652",
            "telephone_number": "207-892-8356",
            "fax_number": "207-892-1644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "936 ROOSEVELT TRL",
            "city": "WINDHAM",
            "state": "ME",
            "postal_code": "040625652",
            "telephone_number": "207-892-8356",
            "fax_number": "207-892-1644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ROY",
        "middle_name": "ALAN",
        "name_suffix": "Jr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-01-14",
        "last_updated": "2010-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ME",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "R",
            "last_name": "MOORE",
            "middle_name": "ALAN",
            "prefix": "DR.",
            "suffix": "JR.",
            "credential": "D.C.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Windham, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2010; 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.