Blake Moser, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH 9926 Issued in FL

Practice address

12086 Fort Caroline Rd
Suite 302
Jacksonville, FL 32225-2687

Phone

(904) 564-2500

Fax

(904) 564-2566

NPI assigned

Apr 12, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

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.

• Jax Spine & Rehab PLLC

  • Chiropractor
  • Jacksonville, FL
  • NPI 1346594322
  Medicare reassignment NPD
• Julington Creek Chiropractic & Wellness Center PA

  • Chiropractor
  • Jacksonville, FL
  • NPI 1477768166
  Medicare reassignment NPD
• Jax Chiropractic PLLC

  • Chiropractor
  • Jacksonville, FL
  • NPI 1366037434
  Authorized official Same address or phone
• Performance Physical Medicine and Rehab

  dba Performance Physical Medicine

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Jacksonville Beach, FL
  • NPI 1720456254
  NPD (past)

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

{
    "created_epoch": "1271030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297728000000",
    "number": "1467778761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12086 FORT CAROLINE RD",
            "address_2": "SUITE 302",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322252687",
            "telephone_number": "904-564-2500",
            "fax_number": "904-564-2566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12086 FORT CAROLINE RD",
            "address_2": "SUITE 302",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322252687",
            "telephone_number": "904-564-2500",
            "fax_number": "904-564-2566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSER",
        "first_name": "BLAKE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-12",
        "last_updated": "2011-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH 9926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mosaic Family Services LLC
• Mosaic Monarch LLC
• Neil I Moscoso, RPT
• Candace Moseley
• Benjamin Douglas Moser, M.D., M.P.H.
• Alex Martin Moses
• Falma Moses, CNA CMA
• Christine Moshe, MD
• Megan Moshea, DDS
• Amy Mosher, PHARM.D.

• Chiropractor in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2011; 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.