Stacey Moon, APRN, MNSC, AGACNPBC

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

124009 Issued in AR

Practice address

3500 Springhill Dr Ste 200a
North Little Rock, AR 72117-2948

Phone

(501) 413-9290

NPI assigned

Nov 6, 2020

Last updated

Nov 6, 2020By the provider in NPPES

Sex

Female

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

Enrolled in AR

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Arkansas Health Group

  dba Baptist Health Specialty Clinic North Little Rock

  • Pulmonary Disease Physician
  • North Little Rock, AR
  • NPI 1396187597
  Medicare reassignment NPD
• Arkansas Health Group

  dba Baptist Health Surgical Clinic-Stuttgart

  • Surgery Physician
  • Stuttgart, AR
  • NPI 1952840555
  NPD

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

{
    "created_epoch": "1604620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604620800000",
    "number": "1184225096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 SPRINGHILL DR STE 200A",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721172948",
            "telephone_number": "501-413-9290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 SPRINGHILL DR STE 200A",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721172948",
            "telephone_number": "501-413-9290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "STACEY",
        "credential": "APRN, MNSC, AGACNPBC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-06",
        "last_updated": "2020-11-06",
        "certification_date": "2020-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AR",
            "license": "124009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael F Moll
• Adam Montgomery, PHARM.D.
• Mary Louise Montgomery, B.S.
• Maurice Moody
• Kerry Moon
• Scott Ryan Mooney, PHD, ABPP
• Tiffany V Mooney, OD
• Aislinn Moore
• Breanna Kishay Moore
• Brett Moore

• Acute Care Nurse Practitioner in North Little Rock, AR
• Providers in North Little Rock, AR by specialty
• Acute Care Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.