Jackson Moran
NPI 1104574680 · Student in an Organized Health Care Education/Training Program · Minneapolis, MN
Enrolled with Medicare as Order and Referring Only - Emergency Medicine · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Jackson Moran is a Student in an Organized Health Care Education/Training Program provider in Minneapolis, MN (NPI 1104574680).
Provider details
- NPI number
- 1104574680
- Entity type
- Individual
- Primary specialty
- Student in an Organized Health Care Education/Training ProgramStudent, Health Care
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Student, Health Care
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
83% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2022-03-14
- Last updated
- 2023-04-07
- Certified
- 2023-04-07
Frequently asked questions
- What is Jackson Moran's NPI number?
- Jackson Moran's National Provider Identifier (NPI) is 1104574680, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Jackson Moran's specialty?
- Jackson Moran is listed in the NPPES registry with a primary specialty of Student in an Organized Health Care Education/Training Program (Student, Health Care).
- Where is Jackson Moran located?
- Jackson Moran's practice location on file with NPPES is 701 Park Ave, Minneapolis, MN 55415-1623.
- What is Jackson Moran's phone number?
- The practice phone number listed in the NPPES registry for Jackson Moran is (612) 873-3000.
- Does Jackson Moran accept Medicare?
- Jackson Moran is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Jackson Moran's NPI active?
- Yes — Jackson Moran's NPI (1104574680) is active in the NPPES registry as of the last update on 2023-04-07.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.