Gabriel Dan Mooney, R.D.

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

2912 Issued in MN

Practice address

600 Main Ave S
Baudette, MN 56623-2855

Phone

(218) 634-2120

Fax

(218) 634-3416

NPI assigned

Apr 23, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1271980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272240000000",
    "number": "1174840672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 MAIN AVE S",
            "city": "BAUDETTE",
            "state": "MN",
            "postal_code": "566232855",
            "telephone_number": "218-634-2120",
            "fax_number": "218-634-3416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 MAIN AVE S",
            "city": "BAUDETTE",
            "state": "MN",
            "postal_code": "566232855",
            "telephone_number": "218-634-2120",
            "fax_number": "218-634-3416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOONEY",
        "first_name": "GABRIEL",
        "middle_name": "DAN",
        "name_prefix": "Mr.",
        "credential": "R.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-23",
        "last_updated": "2010-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MN",
            "license": "2912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychenutrition

• All providers in Baudette, MN
• Registered Dietitian in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.