Kelley E Moon, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

L4067 Issued in TX

Practice address

1320 N University Dr Ste B
Nacogdoches, TX 75961-4270

Phone

(936) 559-9225

Fax

(936) 559-9701

NPI assigned

Jul 11, 2006

Last updated

Jan 21, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jul 1, 2013 through Jul 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/FHDHDD/Endpoint/FHDHDD

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.

• Halifax Healthcare Systems Inc

  dba HHCSI Halifax Family Health Center

  • Family Medicine Physician
  • Daytona Beach, FL
  • NPI 1245283530

  Single Specialty

  NPD (past)
• Halifax Healthcare Systems Inc

  dba HHCSI Halifax Open Heart

  • Cardiovascular Disease Physician
  • Daytona Beach, FL
  • NPI 1366452591

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768953600000",
    "number": "1255366035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 N UNIVERSITY DR STE B",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759614270",
            "telephone_number": "936-559-9225",
            "fax_number": "936-559-9701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 N UNIVERSITY DR STE B",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759614270",
            "telephone_number": "936-559-9225",
            "fax_number": "936-559-9701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "KELLEY",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2026-01-21",
        "certification_date": "2026-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L4067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lawrence Joseph Monlezun, CRNA, MSA
• Emily Montana, MS, LAT, ATC
• Antonio Montilla, LPC
• James Montoya, LBSW
• Tomeka Moody, MS, CCC/SLP
• Moonrise Mental Health PLLC
• Caylee Donice Moore, M.S. CCC-SLP
• Donald Raymond Moore, PHARM. D
• Shannon Maire Morgan, CBE
• Cory Morris

• Family Medicine Physician in Nacogdoches, TX
• Providers in Nacogdoches, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2026; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.