Individual provider Active NPI

Brett A Moran, D.C.

  • Chiropractor
  • Burlington, WI
National Provider Identifier
1609170216
Registry record updated Aug 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4700-012 Issued in WI
Practice address
1448 S Teut Rd
Suite D
Burlington, WI 53105-7251
Phone
(262) 767-0500
NPI assigned
Dec 23, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4700-012 WI Primary

Addresses

Primary practice location

1448 S Teut Rd
Suite D
Burlington, WI 53105-7251

Mailing address

1448 S Teut Rd
Suite D
Burlington, WI 53105-7251
Phone (262) 767-0500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110408000713 WI Practitioner - Chiropractic 0345424750 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

116 N Dodge St
Suite 2
Burlington, WI 53105-1963
Phone (262) 767-0500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4700-012WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Core Chiropractic & Wellness Center, LLC Chiropractor CurrentSince Feb 1, 2011 Accepting new patients

Locations

116 N Dodge St
Ste 2
Burlington, WI 53105
Phone (262) 767-0500

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": "1293062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346198400000",
    "number": "1609170216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1448 S TEUT RD",
            "address_2": "SUITE D",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "531057251",
            "telephone_number": "262-767-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1448 S TEUT RD",
            "address_2": "SUITE D",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "531057251",
            "telephone_number": "262-767-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAN",
        "first_name": "BRETT",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-12-23",
        "last_updated": "2012-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4700-012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.