Individual provider Active NPI

Brian Scott Moravec, DC

  • Chiropractor
  • Escanaba, MI
National Provider Identifier
1497809263
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301008558 Issued in MI
Practice address
500 Ludington St
Escanaba, MI 49829-3926
Phone
(906) 789-5868
Fax
(906) 789-5636
NPI assigned
Jan 22, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301008558 MI Primary

Addresses

Primary practice location

500 Ludington St
Escanaba, MI 49829-3926

Mailing address

500 Ludington St
Escanaba, MI 49829-3926
Phone (906) 789-5868

Other identifiers 2

IdentifierTypeStateIssuer
BLUE CARE NETWORKOtherMIBLUE CARE NETWORK
4688904MedicaidMI

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
2301008558MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Beauchamp Chiropractic Chiropractor PastSince Nov 1, 2004 Accepting new patients

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": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1497809263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 LUDINGTON ST",
            "city": "ESCANABA",
            "state": "MI",
            "postal_code": "498293926",
            "telephone_number": "906-789-5868",
            "fax_number": "906-789-5636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 LUDINGTON ST",
            "city": "ESCANABA",
            "state": "MI",
            "postal_code": "498293926",
            "telephone_number": "906-789-5868",
            "fax_number": "906-789-5636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAVEC",
        "first_name": "BRIAN",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301008558",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE NETWORK",
            "identifier": "BLUE CARE NETWORK",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4688904",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Escanaba, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.