Active NPI
Steven John Moore, D.C.
- Chiropractor
- Saint Peter, MN
National Provider Identifier
1720150188
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2014
- Practice address
- 220 W Broadway Ave
Saint Peter, MN 56082-2036 - Phone
- (507) 934-4850
- NPI assigned
- Nov 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2014 | MN | Primary |
Addresses
Primary practice location
220 W Broadway Ave
Saint Peter, MN 56082-2036
Mailing address
210 W Broadway Ave
Saint Peter, MN 56082-2036
Phone (507) 934-4385
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 69D71MO | Other | MN | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120125000186 | MN | Practitioner - Chiropractic | 4587684162 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2014 | MN | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1720150188",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "210 W BROADWAY AVE",
"city": "SAINT PETER",
"state": "MN",
"postal_code": "560822036",
"telephone_number": "507-934-4385"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "220 W BROADWAY AVE",
"city": "SAINT PETER",
"state": "MN",
"postal_code": "560822036",
"telephone_number": "507-934-4850"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "STEVEN",
"middle_name": "JOHN",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MN",
"license": "2014",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "69D71MO",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Saint Peter, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.