Nicholas Clayton Moe, D.C.

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

5742 Issued in MN

Practice address

7108 Ohms LN
Edina, MN 55439-2140

Phone

(952) 833-3038

Fax

(952) 833-3040

NPI assigned

Mar 6, 2013

Last updated

Feb 21, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Moe Chiropractic PA

  • Sports Physician Chiropractor
  • Edina, MN
  • NPI 1538925292
  NPD Authorized official

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

{
    "created_epoch": "1362528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1427399021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7108 OHMS LN",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554392140",
            "telephone_number": "952-833-3038",
            "fax_number": "952-833-3040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7108 OHMS LN",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554392140",
            "telephone_number": "952-833-3038",
            "fax_number": "952-833-3040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOE",
        "first_name": "NICHOLAS",
        "middle_name": "CLAYTON",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-03-06",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "5742",
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "MN",
            "license": "5742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mobile Diagnostic Imaging, Inc
• Mobility Agility Chiropractic Performance PSC
• Zach Mochinski, D.C.
• Moe Chiropractic PA
• Katie L Moe, CRNA
• Allyson Leigh Moen, PT, DPT, ATC
• Hannah R Moen, DPT, PT
• Steven Alan Moen, M.D.
• Abdimalik Abdi Mohamed
• Ahlaam Mohamed

• Sports Physician Chiropractor in Edina, MN
• Providers in Edina, MN by specialty
• Sports Physician Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2024; 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.