Individual provider Active NPI

Steven Taylor Moon, DNP, CRNA, APRN

  • Certified Registered Nurse Anesthetist
  • Knoxville, TN
National Provider Identifier
1255038444
Registry record updated Sep 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
34659 Issued in TN
Practice address
1924 Alcoa Hwy # U109
Knoxville, TN 37920-1511
Phone
(865) 305-9000
NPI assigned
Feb 8, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2023

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4704339812 MI
Registered Nurse 163W00000X 241120 TN
Certified Registered Nurse Anesthetist 367500000X 4704339812 MI
Student in an Organized Health Care Education/Training Program 390200000X TN
Certified Registered Nurse Anesthetist 367500000X 34659 TN Primary

Addresses

Primary practice location

1924 Alcoa Hwy # U109
Knoxville, TN 37920-1511

Mailing address

1924 Alcoa Hwy # U109
Knoxville, TN 37920-1511

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231025002133 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 8123474285 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1924 Alcoa Hwy
Knoxville, TN 37920-1511
Phone (865) 305-9220

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704339812MIMDRegistered Nurse
241120TNMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
University Anesthesiologists, PLLC Nurse Anesthetist, Certified Registered CurrentSince Nov 1, 2023 Accepting new patients
University Anesthesiologists, PLLC Past Accepting new patients

Locations

1924 Alcoa Hwy
#U109
Knoxville, TN 37920
Phone (865) 305-9220

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1675814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694736000000",
    "number": "1255038444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1924 ALCOA HWY # U109",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379201511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1924 ALCOA HWY # U109",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379201511",
            "telephone_number": "865-305-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "STEVEN",
        "middle_name": "TAYLOR",
        "name_prefix": "Dr.",
        "credential": "DNP, CRNA, APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-02-08",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704339812",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "241120",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704339812",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TN",
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "34659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.