Organization Active NPI

Andrew W Moore DC PC

  • Chiropractor
  • San Antonio, TX
National Provider Identifier
1467716324
Registry record updated Jun 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4749 Issued in TX
Legal business name
ANDREW W MOORE DC PC
Practice address
8507 McCullough Ave
Suite a-1
San Antonio, TX 78216-6458
Phone
(210) 525-9063
Fax
(210) 308-0494
NPI assigned
Jun 26, 2012
Last updated
Jun 26, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2012

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

Authorized official

Name
Dr. Andrew W Moore, DCNPI 1083725444
Title
DC/Owner
Phone
(210) 525-9063

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4749 TX Primary

Addresses

Primary practice location

8507 McCullough Ave
Suite a-1
San Antonio, TX 78216-6458

Mailing address

8507 McCullough Ave
Suite a-1
San Antonio, TX 78216-6458
Phone (210) 525-9063

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120910000335 TX Part B Supplier - Clinic/Group Practice 0941458343 Receives reassigned benefits from 1 practitioner
Practice locations: San Antonio, TX

National Provider Directory

National Provider Directory

Locations

8507 McCullough Ave
Ste A1
San Antonio, TX 78216
Phone (210) 525-9063

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1340668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340668800000",
    "number": "1467716324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8507 MCCULLOUGH AVE",
            "address_2": "SUITE A-1",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782166458",
            "telephone_number": "210-525-9063",
            "fax_number": "210-308-0494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8507 MCCULLOUGH AVE",
            "address_2": "SUITE A-1",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782166458",
            "telephone_number": "210-525-9063",
            "fax_number": "210-308-0494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDREW W MOORE DC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-26",
        "last_updated": "2012-06-26",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "DC/OWNER",
        "authorized_official_telephone_number": "210-525-9063",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "4749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.