Individual provider Active NPI

Audra Jean Moran, DC

  • Chiropractor
  • Atlanta, GA
National Provider Identifier
1376662866
Registry record updated Oct 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR007136 Issued in GA
Practice address
650 Hamilton Ave SE Ste C
Atlanta, GA 30312-3778
Phone
(404) 888-0666
Fax
(404) 888-0590
NPI assigned
Mar 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR007136 GA Primary

Addresses

Primary practice location

650 Hamilton Ave SE Ste C
Atlanta, GA 30312-3778

Mailing address

650 Hamilton Ave SE Ste C
Atlanta, GA 30312-3778
Phone (404) 888-0666

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CHIR007136GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Preferred Chiropractic LLC Chiropractor CurrentSince Mar 6, 2022 Accepting new patients

Locations

650 Hamilton Ave SE
Ste C
Atlanta, GA 30312
Phone (404) 888-0666

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": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635638400000",
    "number": "1376662866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 HAMILTON AVE SE STE C",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303123778",
            "telephone_number": "404-888-0666",
            "fax_number": "404-888-0590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 HAMILTON AVE SE STE C",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303123778",
            "telephone_number": "404-888-0666",
            "fax_number": "404-888-0590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAN",
        "first_name": "AUDRA",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-28",
        "last_updated": "2021-10-31",
        "certification_date": "2021-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR007136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.