Individual provider Active NPI

Christopher A Moran, DC

  • Nutrition Chiropractor
  • Traverse City, MI
National Provider Identifier
1295763019
Registry record updated Nov 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition ChiropractorTaxonomy code 111NN1001X
License
2301006134 Issued in MI
Practice address
3639 Cass Rd
Traverse City, MI 49684-9153
Phone
(231) 943-2100
Fax
(231) 766-6161
NPI assigned
Jun 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Chiropractor 111NN1001X 2301006134 MI Primary

Addresses

Primary practice location

3639 Cass Rd
Traverse City, MI 49684-9153

Mailing address

3639 Cass Rd
Traverse City, MI 49684-9153
Phone (231) 943-2100

Other identifiers 1

IdentifierTypeStateIssuer
OE910270OtherMIBLUE CROSS/BLUE CARE NUMB

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040315001003 MI Practitioner - Chiropractic 3072402098 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3639 Cass Rd
Traverse City, MI 49684-9153
Phone (231) 943-2100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2301006134MIMDNutrition Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Whole Health Regenerative Medicine, PC CurrentSince Jan 21, 2022 Accepting new patients
Moran Health System Inc Nutrition CurrentSince Dec 7, 2003 Accepting new patients

Locations

806 N State St
Ste B
Stanton, MI 48888
Phone (989) 283-2595

806 N State St
Stanton, MI 48888
Phone (989) 831-5218

3639 Cass Rd
Ste 9
Traverse City, MI 49684

3639 Cass Rd
Traverse City, MI 49684
Phone (231) 943-2100

Organizations & group practices 2

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": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1295763019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3639 CASS RD",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496849153",
            "telephone_number": "231-943-2100",
            "fax_number": "231-766-6161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3639 CASS RD",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496849153",
            "telephone_number": "231-943-2100",
            "fax_number": "231-766-6161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAN",
        "first_name": "CHRISTOPHER",
        "middle_name": "A",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "MI",
            "license": "2301006134",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE CARE NUMB",
            "identifier": "OE910270",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2021; 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.