Stephanie M Moon, APRN, BC

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

26NJ00139400 Issued in NJ

Practice address

1072 Justison St
Wilmington, DE 19801-5162

Phone

(302) 660-3378

NPI assigned

Aug 16, 2007

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 NJ

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

Practice roles

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.

• Intellihealth, Inc.

  • Primary Care Clinic/Center
  • Mount Laurel, NJ
  • NPI 1730186784
  NPD (past)
• Visiting Physician Associates of South Jersey LLC

  • Gerontology Nurse Practitioner
  • Hammonton(Elm), NJ
  • NPI 1306993951
  NPD (past)

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

{
    "created_epoch": "1187222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640044800000",
    "number": "1306038955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 PARISH LN",
            "city": "WILLINGBORO",
            "state": "NJ",
            "postal_code": "080462707",
            "telephone_number": "609-234-9665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1072 JUSTISON ST",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198015162",
            "telephone_number": "302-660-3378"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4510 Church Rd",
            "address_purpose": "LOCATION",
            "city": "Mount Laurel",
            "state": "NJ",
            "postal_code": "080542210",
            "country_code": "US",
            "telephone_number": "856-439-0060",
            "fax_number": "856-452-0344",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOON",
        "first_name": "STEPHANIE",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "APRN, BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-16",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ00139400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "st.francis.life@trinityhealthde.medicity.net",
            "affiliation": "N",
            "endpointDescription": "Saint Francis LIFE",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1072 Justison St",
            "city": "Wilmington",
            "state": "DE",
            "country_code": "US",
            "postal_code": "198015162",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Catherine L Montgomery
• Karalynn Angel Montgomery, LCSW, MED
• Katelyn Patricia Montgomery, PA-C
• Heshimu Y Moody
• Lauren Moon, MS, NCC
• Catharine Mooney
• Moore Proactive Solutions (MPS) LLC
• Moore Therapeutic Services LLC
• Alia Moore
• Ariel Gibson Moore, CRNP

• Adult Health Nurse Practitioner in Wilmington, DE
• Providers in Wilmington, DE by specialty
• Adult Health Nurse Practitioner in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 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.