Individual provider Active NPI

Mary Katherine Ratz Mooberry, D.C.

  • Chiropractor
  • Evergreen, CO
National Provider Identifier
1932247103
Registry record updated Jan 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6029 Issued in CO
Practice address
30772 Southview Dr Ste 140
Evergreen, CO 80439-2214
Phone
(303) 670-7777
Fax
(303) 482-1946
NPI assigned
Feb 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Chiropractor 111NP0017X 6029 CO
Chiropractor 111N00000X 6029 CO Primary

Addresses

Primary practice location

30772 Southview Dr Ste 140
Evergreen, CO 80439-2214

Mailing address

30772 Southview Dr Ste 140
Evergreen, CO 80439-2214
Phone (303) 670-7777

Other identifiers 1

IdentifierTypeStateIssuer
6029OtherCOCO CHIROPRACTIC LICENSE #

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081112000574 CO Practitioner - Chiropractic 7315006848 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Western States College of Chiropractic, 2006
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

30772 Southview Dr
Suite 140
Evergreen, CO 80439-2214
Phone (303) 670-7777

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6029COMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Get Moving Chiropractic Clinic, PC Pediatric Chiropractor Current Accepting new patients

Locations

30772 Southview Dr
Ste 140
Evergreen, CO 80439
Phone (303) 670-7777

Organizations & group practices 1

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": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516752000000",
    "number": "1932247103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30772 SOUTHVIEW DR STE 140",
            "city": "EVERGREEN",
            "state": "CO",
            "postal_code": "804392214",
            "telephone_number": "303-670-7777",
            "fax_number": "303-482-1946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30772 SOUTHVIEW DR STE 140",
            "city": "EVERGREEN",
            "state": "CO",
            "postal_code": "804392214",
            "telephone_number": "303-670-7777",
            "fax_number": "303-482-1946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOOBERRY",
        "first_name": "MARY KATHERINE",
        "middle_name": "RATZ",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2018-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NP0017X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Pediatric Chiropractor",
            "state": "CO",
            "license": "6029",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "6029",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CO CHIROPRACTIC LICENSE #",
            "identifier": "6029",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evergreen, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2018; 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.