Individual provider Active NPI

Amy Moon, N.P.

  • Nurse Practitioner
  • Asheboro, NC
National Provider Identifier
1043305121
Registry record updated Dec 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
600124 Issued in NC
Practice address
237 N Fayetteville St Ste D
Asheboro, NC 27203-5573
Phone
(336) 625-2961
Fax
(336) 625-6573
NPI assigned
Oct 4, 2006
Last updated
Dec 1, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 600124 NC Primary

Addresses

Primary practice location

237 N Fayetteville St Ste D
Asheboro, NC 27203-5573

Mailing address

218 Foust St
Ste C
Asheboro, NC 27203-5476
Phone (336) 625-2333

Other identifiers 1

IdentifierTypeStateIssuer
7005252MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101030000191 NC Practitioner - Nurse Practitioner 2668666918 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
American Healthcare Systems LLCGroup PAC ID 7719383538, 64 clinicians

Practice addresses (Care Compare)

237 N Fayetteville St
Suite D
Asheboro, NC 27203-5573
Phone (336) 625-2961

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
600124NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
American Healthcare Systems, LLC CurrentSince Oct 1, 2021 Accepting new patients
American Healthcare Systems, LLC Current Accepting new patients
American Healthcare Systems, LLC CurrentSince Oct 1, 2021 Accepting new patients
American Healthcare Systems, LLC Past Accepting new patients
Internal Medicine Associates of Asheboro, P.C. Internal Medicine Past Accepting new patients

Locations

124 N Park St
Asheboro, NC 27203
Phone (336) 625-1007

218 Foust St
Ste C
Asheboro, NC 27203
Phone (336) 625-2333

237 N Fayetteville St
Ste A
Asheboro, NC 27203
Phone (336) 625-3248

237 N Fayetteville St
Ste D
Asheboro, NC 27203
Phone (336) 625-2961

713 S Fayetteville St
Asheboro, NC 27203
Phone (336) 625-2467

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480550400000",
    "number": "1043305121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 FOUST ST",
            "address_2": "STE C",
            "city": "ASHEBORO",
            "state": "NC",
            "postal_code": "272035476",
            "telephone_number": "336-625-2333",
            "fax_number": "336-625-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "237 N FAYETTEVILLE ST STE D",
            "city": "ASHEBORO",
            "state": "NC",
            "postal_code": "272035573",
            "telephone_number": "336-625-2961",
            "fax_number": "336-625-6573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "AMY",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2016-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "600124",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7005252",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Asheboro, NC

Sources for this page

Verify at the official NPI Registry.