Individual provider Active NPI

Christy Moore, DC

  • Chiropractor
  • Bradenton, FL
National Provider Identifier
1912290677
Registry record updated Oct 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR008820 Issued in GA
Practice address
5620 Tara Blvd Ste 103
Bradenton, FL 34203-8865
Phone
(941) 220-6993
Fax
(941) 220-6969
NPI assigned
May 26, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR008820 GA Primary

Addresses

Primary practice location

5620 Tara Blvd Ste 103
Bradenton, FL 34203-8865

Mailing address

5620 Tara Blvd
Bradenton, FL 34203-8864
Phone (941) 220-6993

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211019002612 FL Practitioner - Chiropractic 3274921515 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5620 Tara Blvd
Suite 103
Bradenton, FL 34203-8865
Phone (941) 220-6993

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIR008820GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Two Palms Chiropractic & Wellness CurrentSince Oct 1, 2021 Accepting new patients
Healthy Life Chiropractic Inc Chiropractor PastSince Feb 4, 2016 Accepting new patients

Locations

5620 Tara Blvd
Ste 103
Bradenton, FL 34203
Phone (941) 220-6993

Organizations & group practices 2

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": "1306368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633824000000",
    "number": "1912290677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5620 TARA BLVD",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342038864",
            "telephone_number": "941-220-6993",
            "fax_number": "941-220-6969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5620 TARA BLVD STE 103",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342038865",
            "telephone_number": "941-220-6993",
            "fax_number": "941-220-6969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "CHRISTY",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-26",
        "last_updated": "2021-10-10",
        "certification_date": "2021-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR008820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2021; 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.