John A Moran, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

20816 Issued in MN

Practice address

1542 Golf Course Rd
Suite 201
Grand Rapids, MN 55744

Phone

(218) 326-3433

Fax

(218) 326-3435

NPI assigned

Aug 24, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Great Northern Opticians

  • Durable Medical Equipment & Medical Supplies
  • Brainerd, MN
  • NPI 1093933483
  NPD (past)

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

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262822400000",
    "number": "1700879756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1542 GOLF COURSE RD",
            "address_2": "SUITE 201",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "55744",
            "telephone_number": "218-326-3433",
            "fax_number": "218-326-3435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1542 GOLF COURSE RD",
            "address_2": "SUITE 201",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "55744",
            "telephone_number": "218-326-3433",
            "fax_number": "218-326-3435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAN",
        "first_name": "JOHN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2010-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MN",
            "license": "20816",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL MEDICARE NUMBER GRAND RAPIDS",
            "identifier": "180001387",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL MEDICARE NUMBER HIBBING",
            "identifier": "180001388",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER NUMBER HIBBING",
            "identifier": "C02738",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GRAND RAPIDS PROVIDER NUMBER",
            "identifier": "C08247",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lorna Mix
• Modern Mojo
• Audrey Moen
• Bonita Lynne Moger, RPH
• Jessica Rae Mohn
• Reid Morrissey, PT, ATC
• Katherine Mostoller
• Jody Murphy, PMHNP-BC
• Keith Murphy, M.D.
• Bradley Robert Nelson, MALP

• Ophthalmology Physician in Grand Rapids, MN
• Providers in Grand Rapids, MN by specialty
• Ophthalmology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2010; 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.