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DR. CAMILLA SUSAN MOORE D.C.
NPI 1639345283
Chiropractor in Providence, RI

Active since May 05, 2008
144 WATERMAN ST, SUITE 2, PROVIDENCE, RI 02906(401) 396-2010(410) 466-4050 Get Directions Write a Review

NPPES record last updated: April 15, 2012. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Camilla Susan Moore D.c. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. CAMILLA SUSAN MOORE D.C. (NPI 1639345283) is an individual chiropractor in Providence, Rhode Island, licensed in Massachusetts (3187) and active in the NPI registry since May 2008. She is a graduate of New York Chiropractic College (2008).

NPPES Registry Identity

NPI1639345283
Entity TypeIndividualFemale
Primary Taxonomy111N00000X
Provider Legal NameDR. CAMILLA SUSAN MOORECredential: D.C.
Location Address144 WATERMAN ST, SUITE 2Providence, RI 02906-2126
Mailing Address17 Burnside StBristol, RI 02809-2003 · (617) 669-3008
Phone(401) 396-2010
Fax(410) 466-4050
Sole ProprietorNo
Medical School CMSNew York Chiropractic CollegeGraduated 2008
Enumeration DateMay 5, 2008
Last NPPES UpdateApril 15, 2012
✔ NPI 1639345283 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers
Taxonomy Code111N00000X
License✔ Licensed in MA · 3187
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
144 WATERMAN ST, Providence, RI 02906
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Camilla Susan Moore D.c. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1557431574
PECOS Enrollment IDI20121121000248

Medicare Billing Reassignments

2

Medicare enrollment records show Camilla Moore reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Lifespan Physician Group, Inc.
1.3 mi
General Practice
593 EDDY ST
Providence, RI 02903
  • Reassigned Medicare billing, Rhode Island enrollment
  • 1,372 clinicians in this Medicare group
NPI 1407116643 (401) 444-6779
Edwards Health LLC
11 mi
Chiropractor
685 METACOM AVE
Bristol, RI 02809
  • Reassigned Medicare billing, Rhode Island enrollment
  • 2 clinicians in this Medicare group
NPI 1326555277 (401) 396-9892

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. LISA SHANE SCHACHTER LICSW
Social Worker
144 WATERMAN ST, SUITE 4
PROVIDENCE, RI 02906
Providence County (401) 751-1923
MS. HEATHER ANN DOLAN D.A.
Acupuncturist
144 WATERMAN ST, SUITE 4
PROVIDENCE, RI 02906
Providence County (401) 421-8074
MS. MELANIE LEE DIANA D.A. (DOCTOR OF ACUP
Acupuncturist
144 WATERMAN ST, SUITE 4
PROVIDENCE, RI 02906
Providence County (401) 273-0404
DR. SEAN A TUTEN D.A.
Acupuncturist
144 WATERMAN ST, SUITE 5
PROVIDENCE, RI 02906
Providence County (401) 569-0222
SEEDS OF CHANGE COACHING AND WELLNESS LLC
Physical Therapist
144 WATERMAN ST
PROVIDENCE, RI 02906
Providence County (401) 787-3627

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Camilla Moore's NPI number?

The NPI number for Camilla Moore is 1639345283. It was assigned to this individual provider in the NPPES registry on May 5, 2008.

Where is Camilla Moore located?

Camilla Moore practices at 144 Waterman St Suite 2, Providence, RI 02906. The listed phone number is (401) 396-2010.

What is Camilla Moore's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Is Camilla Moore enrolled in Medicare?

Yes. Camilla Moore is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Camilla Moore's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Camilla Moore reassigns Medicare benefits to 2 organizations: Lifespan Physician Group, Inc. (Providence, RI) and Edwards Health LLC (Bristol, RI). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Camilla Moore's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Camilla Moore accept?

Health plans from Providence Health Plan list Camilla Moore as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Camilla Moore was last updated on April 15, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.