Phillip Moore, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1083 Issued in AR

Practice address

3609 Highway 367 N
Bald Knob, AR 72010-9404

Phone

(501) 724-2202

Fax

(501) 724-2202

NPI assigned

Mar 24, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Moore Chiropractic Center, P.a.

  • Chiropractor
  • Bald Knob, AR
  • NPI 1215246509
  NPD (past) Authorized official

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283126400000",
    "number": "1962462903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1609",
            "address_2": "3609 HWY 367 N",
            "city": "BALD KNOB",
            "state": "AR",
            "postal_code": "720101609",
            "telephone_number": "501-724-2202",
            "fax_number": "501-724-2202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3609 HIGHWAY 367 N",
            "city": "BALD KNOB",
            "state": "AR",
            "postal_code": "720109404",
            "telephone_number": "501-724-2202",
            "fax_number": "501-724-2202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "PHILLIP",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2010-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AR",
            "license": "1083",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150110718",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5187337",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "59073",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alice Longacre
• Andrea Mason
• Cale E McGillvray, LPC, LMFT
• Brandi Michelle Moody, MCD,CCC-SLP
• Moore Chiropractic Center, P.a.
• Imi Mvere
• Shelly Rutledge, PHARM.D.
• Southern Dental Group Bald Knob, PLLC
• Ladonna Sue Thompson, MSE, CCC/SLP
• Wallace Chiropractic Clinic

• Chiropractor in Bald Knob, AR
• Providers in Bald Knob, AR by specialty
• Chiropractor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.