Jerry A Moon, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2250 Issued in AR

Practice address

509 N 2ND St
Heber Springs, AR 72543-2513

Phone

(501) 362-8191

Fax

(501) 362-3096

NPI assigned

Nov 2, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208390400000",
    "number": "1427049147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2",
            "address_2": "509 N SECOND STREET",
            "city": "HEBER SPRINGS",
            "state": "AR",
            "postal_code": "725430002",
            "telephone_number": "501-362-8191",
            "fax_number": "501-362-3096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 N 2ND ST",
            "city": "HEBER SPRINGS",
            "state": "AR",
            "postal_code": "725432513",
            "telephone_number": "501-362-8191",
            "fax_number": "501-362-3096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "JERRY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2008-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2250",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "71078816172543",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH",
            "identifier": "2220019",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kayla Medley
• Jenna-Lee Melnick
• Douglas S Miller, DDS
• Bruce G Mitchell, MD
• Moon Eye Clinic, P.a.
• Natural Springs Emergency Physicians LLC
• Newport Hospital Medical Supply
• Noland Dental PLLC
• Charles Conner Noland
• Joey Nugent, OD

• Optometrist in Heber Springs, AR
• Providers in Heber Springs, AR by specialty
• Optometrist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2008; 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.