Individual provider Active NPI

Kate Moon, NP-BC

  • Family Medicine Physician
  • Flower Mound, TX
National Provider Identifier
1366321937
Registry record updated Aug 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1069585 Issued in TX
Practice address
2601 Lakeside Pkwy Ste 180
Flower Mound, TX 75022-4291
Phone
(972) 874-0008
NPI assigned
Aug 28, 2025
Last updated
Aug 28, 2025By the provider in NPPES
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 1069585 TX Primary

Addresses

Primary practice location

2601 Lakeside Pkwy Ste 180
Flower Mound, TX 75022-4291

Mailing address

3129 Berkeley Ave
Copper Canyon, TX 75077-8483
Phone (860) 882-7400

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

State licenses

LicenseStateTypeSpecialty
1069585TXMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1756339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756339200000",
    "number": "1366321937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3129 BERKELEY AVE",
            "city": "COPPER CANYON",
            "state": "TX",
            "postal_code": "750778483",
            "telephone_number": "860-882-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 LAKESIDE PKWY STE 180",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750224291",
            "telephone_number": "972-874-0008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "KATE",
        "credential": "NP-BC",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-08-28",
        "last_updated": "2025-08-28",
        "certification_date": "2025-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "1069585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flower Mound, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.