Active NPI
Jeff C Moon, D.O.
- Occupational Medicine Physician
- North Las Vegas, NV
National Provider Identifier
1366561227
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Medicine Physician
- License
- 923
- Practice address
- 2621 Losee Rd
North Las Vegas, NV 89030-4129 - Phone
- (702) 295-6566
- Fax
- (702) 295-4323
- NPI assigned
- Mar 29, 2007
- Last updated
- Apr 23, 2013
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Occupational Medicine Physician | 2083X0100X | 923 | NV | Primary |
Addresses
Primary practice location
2621 Losee Rd
North Las Vegas, NV 89030-4129
Mailing address
2621 Losee Rd
North Las Vegas, NV 89030-4129
Phone (702) 295-6566
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Oct 3, 2023 through Oct 3, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 923 | NV | MD | Occupational Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1366675200000",
"number": "1366561227",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2621 LOSEE RD",
"city": "NORTH LAS VEGAS",
"state": "NV",
"postal_code": "890304129",
"telephone_number": "702-295-6566",
"fax_number": "702-295-4323"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2621 LOSEE RD",
"city": "NORTH LAS VEGAS",
"state": "NV",
"postal_code": "890304129",
"telephone_number": "702-295-6566",
"fax_number": "702-295-4323"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOON",
"first_name": "JEFF",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-29",
"last_updated": "2013-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "2083X0100X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Occupational Medicine",
"state": "NV",
"license": "923",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2013; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.