NPIMap

Organization Active NPI

Jill Moore LLC

Doing business as DeepWave Regenerative Therapy

  • Chiropractor
  • Bel Air, MD
National Provider Identifier
1730328048
Registry record updated Jul 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
S03572 Issued in MD
Legal business name
JILL MOORE LLC
Doing business as
DeepWave Regenerative Therapy
Live Well Family Chiropractic
Practice address
21 Eastern Ave
Bel Air, MD 21014-3902
Phone
(410) 790-8524
NPI assigned
Feb 10, 2009
Last updated
Jul 15, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2026

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

Authorized official

Name
Jill Moore, D.C.NPI 1124266101
Title
Owner
Phone
(410) 995-7312

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X S03572 MD Primary

Addresses

Primary practice location

21 Eastern Ave
Bel Air, MD 21014-3902

Mailing address

1213 Midwood CT
Bel Air, MD 21014-2546
Phone (410) 790-8524

Other names 2

  • DeepWave Regenerative Therapy Doing business as
  • Live Well Family Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090430000016 MD Part B Supplier - Clinic/Group Practice 1658429790 Receives reassigned benefits from 1 practitioner
Practice locations: Bel Air, MD

National Provider Directory

National Provider Directory
Tax ID family
Jill Moore LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

208 S Philadelphia Blvd
Aberdeen, MD 21001
Phone (410) 273-5900

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1234224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784073600000",
    "number": "1730328048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1213 MIDWOOD CT",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210142546",
            "telephone_number": "410-790-8524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 EASTERN AVE",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210143902",
            "telephone_number": "410-790-8524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JILL MOORE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-10",
        "last_updated": "2026-07-15",
        "certification_date": "2026-07-15",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "JILL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-995-7312",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "S03572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DeepWave Regenerative Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Live Well Family Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Live Well Family Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bel Air, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2026; 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.

Verify at the official NPI Registry.