Individual provider Active NPI

Alexander Wyckoff Moore, DC, IVCA CERT

  • Chiropractor
  • Peachtree Corners, GA
National Provider Identifier
1467925263
Registry record updated Jan 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR010146 Issued in GA
Practice address
3845 Meadow Green CT
Peachtree Corners, GA 30092-5209
Phone
(443) 370-4845
NPI assigned
Jan 4, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR010146 GA Primary

Addresses

Primary practice location

3845 Meadow Green CT
Peachtree Corners, GA 30092-5209

Mailing address

3845 Meadow Green CT
Peachtree Corners, GA 30092-5209
Phone (443) 370-4845

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
CHIR010146GAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1546560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546560000000",
    "number": "1467925263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3845 MEADOW GREEN CT",
            "city": "PEACHTREE CORNERS",
            "state": "GA",
            "postal_code": "300925209",
            "telephone_number": "443-370-4845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3845 MEADOW GREEN CT",
            "city": "PEACHTREE CORNERS",
            "state": "GA",
            "postal_code": "300925209",
            "telephone_number": "443-370-4845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ALEXANDER",
        "middle_name": "WYCKOFF",
        "name_prefix": "Dr.",
        "credential": "DC, IVCA CERT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-01-04",
        "last_updated": "2019-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR010146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peachtree Corners, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2019; 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.