Organization Active NPI

Moon and Associates, LLC

  • Obstetrics & Gynecology Physician
  • Carmel, IN
National Provider Identifier
1013574102
Registry record updated Sep 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
MOON AND ASSOCIATES, LLC
Practice address
12400 N Meridian St Ste 100
Carmel, IN 46032-4601
Phone
(317) 559-3320
NPI assigned
May 23, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2019

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

Authorized official

Name
Amy L Holland, MD
Title
Member
Phone
(317) 559-3320

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

12400 N Meridian St Ste 100
Carmel, IN 46032-4601

Mailing address

12400 N Meridian St Ste 100
Carmel, IN 46032-4601

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190719001339 IN Part B Supplier - Clinic/Group Practice 4284960816 Receives reassigned benefits from 4 practitioners
Practice locations: Carmel, IN

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D2169674Moon and Associates LLC12400 N Meridian St, Suite 100, Carmel, IN 46032Provider-performed microscopyJul 23, 2027

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19786/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1558569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568937600000",
    "number": "1013574102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12400 N MERIDIAN ST STE 100",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460324601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12400 N MERIDIAN ST STE 100",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460324601",
            "telephone_number": "317-559-3320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOON AND ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-23",
        "last_updated": "2019-09-20",
        "status": "A",
        "authorized_official_last_name": "HOLLAND",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "317-559-3320",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmel, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2019; 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.