Individual provider Active NPI

George R Moon, D.C.

  • Chiropractor
  • Naples, FL
National Provider Identifier
1235222811
Registry record updated Mar 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH0002882 Issued in FL
Practice address
1190 Pine Ridge Rd
Naples, FL 34108-8914
Phone
(239) 261-1387
Fax
(239) 263-8780
NPI assigned
Oct 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH0002882 FL Primary

Addresses

Primary practice location

1190 Pine Ridge Rd
Naples, FL 34108-8914

Mailing address

1190 Pine Ridge Rd
Naples, FL 34108-8914
Phone (239) 261-1387

Other identifiers 1

IdentifierTypeStateIssuer
88366OtherFLBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101025000343 FL Practitioner - Chiropractic 1254523525 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH0002882FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
George R. Moon DC PA Chiropractor CurrentSince Apr 15, 1978 Accepting new patients
Trudy Moon Eisel, D.C., P.a. Chiropractor PastSince Jul 22, 2009 Accepting new patients

Locations

1190 Pine Ridge Rd
Ste 1
Naples, FL 34108
Phone (239) 261-1387

1190 Pine Ridge Rd
Naples, FL 34108
Phone (239) 261-1387

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395964800000",
    "number": "1235222811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1190 PINE RIDGE RD",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341088914",
            "telephone_number": "239-261-1387",
            "fax_number": "239-263-8780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1190 PINE RIDGE RD",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341088914",
            "telephone_number": "239-261-1387",
            "fax_number": "239-263-8780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "GEORGE",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2014-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH0002882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "88366",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.