Individual provider Active NPI

John Moore, DC

  • Chiropractor
  • Sunrise, FL
National Provider Identifier
1346365749
Registry record updated Nov 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH9974 Issued in FL
Practice address
1330 SW 160TH Ave
Sunrise, FL 33326-1907
Phone
(954) 384-3275
Fax
(954) 446-6590
NPI assigned
Mar 21, 2007
Last updated
Nov 6, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3212 NC
Chiropractor 111N00000X CH9974 FL Primary

Addresses

Primary practice location

1330 SW 160TH Ave
Sunrise, FL 33326-1907

Mailing address

1330 SW 160TH Ave
Sunrise, FL 33326-1907
Phone (954) 384-3275

Other practice location 1

5817 Lake Worth Rd
Greenacres, FL 33463-3209
Phone (561) 642-9500

Other identifiers 1

IdentifierTypeStateIssuer
89085T4MedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240304001099 FL Practitioner - Chiropractic 5597741967 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Live Well Chiropractic PLLCGroup PAC ID 0749459428, 2 clinicians

Practice addresses (Care Compare)

1330 SW 160TH Ave
Sunrise, FL 33326-1907
Phone (954) 384-3275

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH9974FLMDChiropractor
3212NCMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Moore Family Chiropractic Chiropractor PastSince Feb 11, 2004 Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604620800000",
    "number": "1346365749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 SW 160TH AVE",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333261907",
            "telephone_number": "954-384-3275",
            "fax_number": "954-446-6590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 SW 160TH AVE",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333261907",
            "telephone_number": "954-384-3275",
            "fax_number": "954-446-6590"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5817 Lake Worth Rd",
            "address_purpose": "LOCATION",
            "city": "Greenacres",
            "state": "FL",
            "postal_code": "334633209",
            "country_code": "US",
            "telephone_number": "561-642-9500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2020-11-06",
        "certification_date": "2020-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "3212",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH9974",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89085T4",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunrise, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2020; 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.