Individual provider Active NPI

David J Moreland, D C

  • Chiropractor
  • Rolla, MO
National Provider Identifier
1679630511
Registry record updated Jun 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CE006386 Issued in MO
Practice address
1410 E State Route 72
Rolla, MO 65401-3987
Phone
(573) 364-8086
Fax
(573) 364-2244
NPI assigned
Jan 2, 2007
Last updated
Jun 16, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CE006386 MO Primary

Addresses

Primary practice location

1410 E State Route 72
Rolla, MO 65401-3987

Mailing address

1410 E State Route 72
Rolla, MO 65401-3987
Phone (573) 364-8086

Other identifiers 1

IdentifierTypeStateIssuer
119192OtherMOBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080619000205 MO Practitioner - Chiropractic 8123199148 Practice locations: Rolla, MO

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1410 E State Route 72
Rolla, MO 65401-3987
Phone (573) 364-8086

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CE006386MOMDChiropractor

Interoperability endpoints

  • Direct secure messaging: david@mc0002.direct.chirotouch.md

NPI Registry JSON

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213574400000",
    "number": "1679630511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 E STATE ROUTE 72",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654013987",
            "telephone_number": "573-364-8086",
            "fax_number": "573-364-2244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 E STATE ROUTE 72",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654013987",
            "telephone_number": "573-364-8086",
            "fax_number": "573-364-2244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORELAND",
        "first_name": "DAVID",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2008-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "CE006386",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "119192",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rolla, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; 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.