Laura E Moon, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

RN144320 Issued in GA

Practice address

1021 Jamestown Blvd Ste 215
Watkinsville, GA 30677-4176

Phone

(706) 389-2273

Fax

(706) 389-2298

NPI assigned

Jan 14, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1547424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1265906226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 48089",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306048089",
            "telephone_number": "706-389-3740",
            "fax_number": "706-389-3951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 JAMESTOWN BLVD STE 215",
            "city": "WATKINSVILLE",
            "state": "GA",
            "postal_code": "306774176",
            "telephone_number": "706-389-2273",
            "fax_number": "706-389-2298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "LAURA",
        "middle_name": "E",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-14",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "RN144320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "stmaryspalliativecare@605.direct.myezyaccess.com",
            "affiliation": "N",
            "endpointDescription": "SMPC Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1021 Jamestown Blvd Ste 215",
            "city": "Watkinsville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "306774176",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Diana Molina, RBT
• Charity Grace Moncada, RD
• Susan Mongerson
• Kelly Pascual Montgomery, M.D.
• Keera Moody
• Maggie Mac Kenzie Moore
• Makienze Moore
• Hiltsy Morales Rivera
• James Patrick Morrison, MD
• William Todd Morrison, LCSW

• Adult Health Nurse Practitioner in Watkinsville, GA
• Providers in Watkinsville, GA by specialty
• Adult Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.