Individual provider Active NPI

Moses Sarah Smith, D.C.

  • Chiropractor
  • Minneapolis, MN
National Provider Identifier
1841372323
Registry record updated Dec 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4728 Issued in MN
Practice address
707 W 34TH St
Minneapolis, MN 55408-4138
Phone
(612) 824-1829
Fax
(612) 823-3808
NPI assigned
Oct 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4728 MN Primary

Addresses

Primary practice location

707 W 34TH St
Minneapolis, MN 55408-4138

Mailing address

707 W 34TH St
Minneapolis, MN 55408-4138
Phone (952) 250-4663

Other identifiers 2

IdentifierTypeStateIssuer
954603100MedicaidMN
273P1ACOtherMNBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050920000062 MN Practitioner - Chiropractic 2466485537 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dr Moses S M Smith Chiropractic LLCGroup PAC ID 3476586546, 2 clinicians

Practice addresses (Care Compare)

3541 Lyndale Ave S
Minneapolis, MN 55408-4159
Phone (612) 824-1829

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4728MNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Moses S M Smith Chiropractic LLC Chiropractor CurrentSince Sep 5, 2005 Accepting new patients
Lucky Cat Acupuncture and Herbal Medicine Past Accepting new patients
Steven D. Moe, Inc. Chiropractor Past Accepting new patients
Moe Chiro Tres PLLC Chiropractor PastSince Sep 27, 2019 Accepting new patients
Gilmore Chiropractic PLLC Chiropractor Past Accepting new patients

Locations

6409 City West Pkwy
Eden Prairie, MN 55344
Phone (952) 250-4663

3541 Lyndale Ave S
Minneapolis, MN 55408
Phone (612) 824-1829

2415 Hennepin Ave
Minneapolis, MN 55405
Phone (612) 372-9133

707 W 34th St
Minneapolis, MN 55408
Phone (612) 327-0408

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260921600000",
    "number": "1841372323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 W 34TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554084138",
            "telephone_number": "952-250-4663",
            "fax_number": "612-823-3808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 W 34TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554084138",
            "telephone_number": "612-824-1829",
            "fax_number": "612-823-3808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MOSES",
        "middle_name": "SARAH",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2009-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4728",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "954603100",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "273P1AC",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2009; 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.