Theresa Moon

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

THERESA MOON

Practice address

565 Lynbrook Rd
Rustburg, VA 24588-3574

Phone

(434) 821-2114

Fax

(434) 821-4734

NPI assigned

Aug 16, 2010

Last updated

Aug 16, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Theresa G. Moon

Title

Service Facilitator

Phone

(434) 821-2114

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1281916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281916800000",
    "number": "1184939019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "565 LYNBROOK RD",
            "city": "RUSTBURG",
            "state": "VA",
            "postal_code": "245883574",
            "telephone_number": "434-821-2114",
            "fax_number": "434-821-4734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "565 LYNBROOK RD",
            "city": "RUSTBURG",
            "state": "VA",
            "postal_code": "245883574",
            "telephone_number": "434-821-2114",
            "fax_number": "434-821-4734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERESA MOON",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-16",
        "last_updated": "2010-08-16",
        "status": "A",
        "authorized_official_last_name": "MOON",
        "authorized_official_first_name": "THERESA",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "SERVICE FACILITATOR",
        "authorized_official_telephone_number": "434-821-2114",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0157008159",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joseph Strasshofer
• Alexandra M Sullivan, PHYSICAL THERAPIST
• Kenneth Swanson, NP
• Thomas Aaron Tascone, B.C.P.C.
• Hallie Cornelia Thaxton, BS
• Tamara Tinnin, DNP APRN CPNP-PC
• Patrick M Todd, DDS
• Danielle Torres
• Angela B Vendetti
• Matthew Wallin, ED.S.

• Case Management Agency in Rustburg, VA
• Providers in Rustburg, VA by specialty
• Case Management Agency in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 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.