Individual provider Active NPI

Devi Dove Moon

  • Family Nurse Practitioner
  • Columbus, MS
National Provider Identifier
1407469638
Registry record updated Jul 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
904108 Issued in MS
Practice address
56 Dutch LN
Columbus, MS 39702-5500
Phone
(662) 329-3808
Fax
(662) 329-3873
NPI assigned
Aug 27, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2026

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 904108 MS Primary

Addresses

Primary practice location

56 Dutch LN
Columbus, MS 39702-5500

Mailing address

56 Dutch LN
Columbus, MS 39702-5500
Phone (662) 329-3808

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20230418000672 MS Practitioner - Nurse Practitioner 2264807650 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dutch Medical Clinics, IncGroup PAC ID 9234376088, 28 clinicians

Practice addresses (Care Compare)

56 Dutch LN
Columbus, MS 39702-5500
Phone (662) 329-3808

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dutch Medical Clinics, Inc CurrentSince Apr 1, 2023 Accepting new patients
Dutch Medical Clinics, Inc. Family Past Accepting new patients

Locations

3654B New Hope Rd
Columbus, MS 39702
Phone (662) 329-1488

3600 Bluecutt Rd
Ste 101
Columbus, MS 39705
Phone (662) 570-4770

3600 Bluecutt Rd
Columbus, MS 39705
Phone (662) 570-4770

56 Dutch Ln
Columbus, MS 39702
Phone (662) 329-3808

Interoperability endpoints

  • Direct secure messaging: devi.moon.1@17762.direct.athenahealth.com

Organizations & group practices 2

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": "1598486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784764800000",
    "number": "1407469638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 DUTCH LN",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397025500",
            "telephone_number": "662-329-3808",
            "fax_number": "662-329-3873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 DUTCH LN",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397025500",
            "telephone_number": "662-329-3808",
            "fax_number": "662-329-3873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "DEVI",
        "middle_name": "DOVE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-27",
        "last_updated": "2026-07-23",
        "certification_date": "2026-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "904108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, MS

Sources for this page

Verify at the official NPI Registry.