NPIMap

Individual provider Active NPI

Heather Nancy Moon, ARNP

  • Adult Health Nurse Practitioner
  • Homer, AK
National Provider Identifier
1205547205
Registry record updated Sep 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
200972 Issued in AK
Practice address
263 W Fairview Ave
Homer, AK 99603-7032
Phone
(907) 435-3070
Fax
(855) 202-9120
NPI assigned
Dec 9, 2022
Last updated
Sep 21, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 200972 AK Primary
Gerontology Nurse Practitioner 363LG0600X 200972 AK

Addresses

Primary practice location

263 W Fairview Ave
Homer, AK 99603-7032

Mailing address

4300 Bartlett St
Homer, AK 99603-7000
Phone (907) 235-8101

Other identifiers 3

IdentifierTypeStateIssuer
NURR32396OtherAKNURSE LICENSE RN
1735468MedicaidAK
200972OtherAKNURSE LICENSE APRN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230127000777 AK Practitioner - Nurse Practitioner 0244601391 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

32923 Solstice St
Soldotna, AK 99669-9569

36955 Hakala Rd
Soldotna, AK 99669-6804

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
200972AKMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South Peninsula Hospital, Inc CurrentSince Apr 1, 2025 Accepting new patients
Odyssey Urgent Care and Occupational Health CurrentSince Jan 14, 2024 Accepting new patients
Brookside Medical Home Visits LLC CurrentSince May 1, 2024 Accepting new patients
South Peninsula Hospital, Inc. CurrentSince Apr 1, 2025 Accepting new patients
Brookside Medical Home Visits LLC CurrentSince May 1, 2024 Accepting new patients

Locations

4300 Bartlett St
Homer, AK 99603
Phone (907) 235-0369

11595 Kenai Spur Hwy
Kenai, AK 99611
Phone (907) 313-4569

Interoperability endpoints

  • Direct secure messaging: heather.moon.1@14977.direct.athenahealth.com
  • Direct secure messaging: heather.moon.3@28056.direct.athenahealth.com

Organizations & group practices 5

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.

Hospital & facility affiliations 20

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1670544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789948800000",
    "number": "1205547205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 BARTLETT ST",
            "city": "HOMER",
            "state": "AK",
            "postal_code": "996037000",
            "telephone_number": "907-235-8101",
            "fax_number": "855-202-9120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 W FAIRVIEW AVE",
            "city": "HOMER",
            "state": "AK",
            "postal_code": "996037032",
            "telephone_number": "907-435-3070",
            "fax_number": "855-202-9120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "HEATHER",
        "middle_name": "NANCY",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-09",
        "last_updated": "2026-09-21",
        "certification_date": "2026-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AK",
            "license": "200972",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "AK",
            "license": "200972",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE LICENSE RN",
            "identifier": "NURR32396",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1735468",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE LICENSE APRN",
            "identifier": "200972",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Homer, AK

Sources for this page

Verify at the official NPI Registry.