Active NPI
Abby Moon, OTR/L
- Occupational Therapist
- Royston, GA
National Provider Identifier
1164073516
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- Practice address
- 613 Cook St
Royston, GA 30662-3933 - Phone
- (706) 491-5409
- NPI assigned
- Sep 26, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | Primary |
Addresses
Primary practice location
613 Cook St
Royston, GA 30662-3933
Mailing address
516 Oconee LN
Commerce, GA 30529-4182
Phone (706) 491-5409
Other practice location 1
516 Oconee Ln
Commerce, GA 30529-4182
Phone (706) 491-5409
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shining Star Therapy Services, LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Speech-Language Pathologist
- Commerce, GA
- NPI 1861840647
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1569456000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1569456000000",
"number": "1164073516",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "516 OCONEE LN",
"city": "COMMERCE",
"state": "GA",
"postal_code": "305294182",
"telephone_number": "706-491-5409"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "613 COOK ST",
"city": "ROYSTON",
"state": "GA",
"postal_code": "306623933",
"telephone_number": "706-491-5409"
}
],
"practiceLocations": [
{
"address_1": "516 Oconee Ln",
"address_purpose": "LOCATION",
"city": "Commerce",
"state": "GA",
"postal_code": "305294182",
"country_code": "US",
"telephone_number": "706-491-5409",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MOON",
"first_name": "ABBY",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-26",
"last_updated": "2019-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Royston, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.