Camilla Susan Moore, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3187 Issued in MA

Practice address

144 Waterman St
Suite 2
Providence, RI 02906-2126

Phone

(401) 396-2010

Fax

(410) 466-4050

NPI assigned

May 5, 2008

Sex

Female

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 RI

Enrollment records 1

Specialty

Chiropractic

Education

New York Chiropractic College, 2008

Medicare assignment

May accept Medicare assignment

Group practices

Edwards Health LLCGroup PAC ID 2163782913, 2 clinicians

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Edwards Health LLC

  • Chiropractor
  • Bristol, RI
  • NPI 1326555277
  Medicare reassignment Care Compare group
• Lifespan Physician Group, Inc.

  • General Practice Physician
  • Providence, RI
  • NPI 1407116643
  Medicare reassignment
• Chiropractic Performance Center, Inc.

  • Chiropractor
  • Providence, RI
  • NPI 1821355843
  NPD (past)
• Zola Chiropractic Center Inc

  • Chiropractor
  • Providence, RI
  • NPI 1710094693
  NPD (past)

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

{
    "created_epoch": "1209945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334448000000",
    "number": "1639345283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 BURNSIDE ST",
            "city": "BRISTOL",
            "state": "RI",
            "postal_code": "028092003",
            "telephone_number": "617-669-3008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 WATERMAN ST",
            "address_2": "SUITE 2",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029062126",
            "telephone_number": "401-396-2010",
            "fax_number": "410-466-4050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "CAMILLA",
        "middle_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-05",
        "last_updated": "2012-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "3187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sydney Sumi Moon, M.D.
• Jacob Mooney
• Moonstone Mothering Perinatal Services LLC
• Pamela Susan Moorby, RN
• Ashley Moore, M.A.,C.A.G.S.,C.R.C.
• Kimberly Ann Moore
• Mary C Moore, PH.D.
• Richard Anthony Moore, M.D.
• Sarah Anne Moore
• Shadae Moore

• Chiropractor in Providence, RI
• Providers in Providence, RI by specialty
• Chiropractor in Rhode Island

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