Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jackson T Moran

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1104574680

Jackson T Moran is an Emergency Medicine in Minneapolis, Minnesota. Graduated from University of Chicago, Pritzker School of Medicine in 2023, 3 years ago. Registered with an NPI since 2022.

Years since qualifying
3
Trained at
University of Chicago, Pritzker School of Medicine
In the registry since
2022
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Practice location Address checks out

701 Park Ave
Minneapolis, MN 55415-1623
Phone: (612) 873-3000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1104574680
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMarch 14, 2022
Last updated in NPPESApril 7, 2023
Certification dateApril 7, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyEMERGENCY MEDICINE
Medical schoolUNIVERSITY OF CHICAGO, PRITZKER SCHOOL OF MEDICINE
Graduated 2023 (3 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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