Jason Dewitt Moore, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1087 Issued in ND

Practice address

2204 2ND Ave W Ste 102
Williston, ND 58801-3485

Phone

(701) 577-7771

NPI assigned

Jan 23, 2019

Last updated

Mar 16, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Moore Chiropractic and Neuropathy, Inc.

  • Chiropractor
  • Alamo, CA
  • NPI 1780552422
  NPD Authorized official

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

{
    "created_epoch": "1548201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584316800000",
    "number": "1629532734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2204 2ND AVE W STE 102",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "588013485",
            "telephone_number": "701-577-7771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2204 2ND AVE W STE 102",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "588013485",
            "telephone_number": "701-577-7771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JASON",
        "middle_name": "DEWITT",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-01-23",
        "last_updated": "2020-03-16",
        "certification_date": "2020-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ND",
            "license": "1087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIROPRACTIC STATE BOARD",
            "identifier": "1087",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Montgomery Counseling Service PLLC
• Christine Renee Montgomery, BA/LAC
• Moor Mind Matters LLC
• McKenzie Larae Moor, PMHNP
• Chelsey Rae Moore, MSW,LSW
• Glenn P Moradian, MD
• Alesha M Morken, LSW
• Angele Morris
• Christina Marie Morris
• Kelsey Muller

• Chiropractor in Williston, ND
• Providers in Williston, ND by specialty
• Chiropractor in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2020; 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.