Individual provider Active NPI

Linda Davis-Moon, CRNP

  • Family Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1326245598
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP004940B Issued in PA
Practice address
1020 Sansom St.
239 Thompson BLDG.
Philadelphia, PA 19107
Phone
(215) 955-6844
Fax
(215) 923-6225
NPI assigned
Jun 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP004940B PA Primary

Addresses

Primary practice location

1020 Sansom St.
239 Thompson BLDG.
Philadelphia, PA 19107

Mailing address

1020 Sansom St.
239 Thompson BLDG.
Philadelphia, PA 19107
Phone (215) 955-6844

Other identifiers 1

IdentifierTypeStateIssuer
SP004940BOtherPACRNP LICENSE

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20040920001267 PA Practitioner - Nurse Practitioner 3274501028 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians

Practice addresses (Care Compare)

1020 Sansom St
Suite 239
Philadelphia, PA 19107-5002
Phone (215) 955-6844

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson Acute Care Physicians, PC CurrentSince Jan 1, 2017 Accepting new patients
Jefferson Acute Care Physicians, PC CurrentSince Jan 1, 2017 Accepting new patients
Jefferson University Physicians CurrentSince Feb 1, 2012 Accepting new patients
Jefferson University Physicians Past Accepting new patients
Jefferson University Physicians Past Accepting new patients

Locations

700 Walnut St
Philadelphia, PA 19106
Phone (215) 503-7300

1020 Sansom St
Fl 2
Philadelphia, PA 19107
Phone (215) 955-0844

2301 S Broad St
Fl 1
Philadelphia, PA 19148
Phone (215) 952-9136

1020 Sansom St
#239
Philadelphia, PA 19107
Phone (215) 955-6844

1020 Sansom St
#10
Philadelphia, PA 19107

1020 Sansom St
Ste 239
Philadelphia, PA 19107
Phone (215) 955-6844

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

Organizations & group practices 5

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": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1326245598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 SANSOM ST.",
            "address_2": "239 THOMPSON BLDG.",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19107",
            "telephone_number": "215-955-6844",
            "fax_number": "215-923-6225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 SANSOM ST.",
            "address_2": "239 THOMPSON BLDG.",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19107",
            "telephone_number": "215-955-6844",
            "fax_number": "215-923-6225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS-MOON",
        "first_name": "LINDA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-29",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP004940B",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRNP LICENSE",
            "identifier": "SP004940B",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.