Moonlight Medical Clinic LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

MOONLIGHT MEDICAL CLINIC LLC

Practice address

3556 Tundra Swan St
Las Vegas, NV 89122-3501

Phone

(725) 207-4335

NPI assigned

Apr 15, 2025

Last updated

May 7, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jamie Codie Diamond

Title

Owner

Phone

(725) 207-4335

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1744675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746576000000",
    "number": "1366238578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3556 TUNDRA SWAN ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891223501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3556 TUNDRA SWAN ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891223501",
            "telephone_number": "725-207-4335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOONLIGHT MEDICAL CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-15",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A",
        "authorized_official_last_name": "DIAMOND",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_middle_name": "CODIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "725-207-4335"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronald Lavor Moon, CST/CSFA
• Moonbeam Therapy LLC
• Brittni Montana Mooney, M.S.
• Julie Alisha Mooney, PA
• Sheila Ann Mooney
• Moonrise Therapy, PLLC
• Jacqui Mooradian, LPTA
• Moore Family Dentistry
• Moore Family Dentistry LLC
• Pauline Sylvia Moore Yannuzzi

• Multi-Specialty Clinic/Center in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Multi-Specialty Clinic/Center in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.