Active NPI
Julie Moon, CNM, ARNP
- Advanced Practice Midwife
- Fairbanks, AK
National Provider Identifier
1306260443
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Advanced Practice Midwife
- License
- 1400
- Practice address
- 2054 30TH Ave
Fairbanks, AK 99701-7316 - Phone
- (907) 456-3719
- NPI assigned
- Feb 10, 2014
- Last updated
- Feb 10, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Advanced Practice Midwife | 367A00000X | 1400 | AK | Primary |
Addresses
Primary practice location
2054 30TH Ave
Fairbanks, AK 99701-7316
Mailing address
2054 30TH Ave
Fairbanks, AK 99701-7316
Phone (907) 456-3719
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Certified Nurse Midwife
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1400 | AK | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mat-Su Birth Center, LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Birthing Clinic/Center
- Wasilla, AK
- NPI 1629137799
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1391990400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1391990400000",
"number": "1306260443",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2054 30TH AVE",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "997017316",
"telephone_number": "907-456-3719"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2054 30TH AVE",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "997017316",
"telephone_number": "907-456-3719"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOON",
"first_name": "JULIE",
"credential": "CNM, ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-02-10",
"last_updated": "2014-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "367A00000X",
"taxonomy_group": "",
"desc": "Advanced Practice Midwife",
"state": "AK",
"license": "1400",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fairbanks, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.