Active NPI
Dawn Marie Luellen Moon, PT
- Physical Therapist
- Landover, MD
National Provider Identifier
1184195455
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 20655
- Practice address
- 1400 Nalley Ter
Landover, MD 20785-4434 - Phone
- (443) 975-1536
- NPI assigned
- Dec 16, 2018
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 20655 | MD | Primary |
Addresses
Primary practice location
1400 Nalley Ter
Landover, MD 20785-4434
Mailing address
2002 Callaway St
Temple Hills, MD 20748-4353
Phone (301) 702-3870
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20655 | MD | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1544918400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1552003200000",
"number": "1184195455",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2002 CALLAWAY ST",
"city": "TEMPLE HILLS",
"state": "MD",
"postal_code": "207484353",
"telephone_number": "301-702-3870"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 NALLEY TER",
"city": "LANDOVER",
"state": "MD",
"postal_code": "207854434",
"telephone_number": "443-975-1536"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOON",
"first_name": "DAWN MARIE",
"middle_name": "LUELLEN",
"name_prefix": "Dr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-12-16",
"last_updated": "2019-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "20655",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Landover, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 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.