Organization Active NPI

George R. Moon DC PA

  • Chiropractor
  • Naples, FL
National Provider Identifier
1437339132
Registry record updated Jan 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
GEORGE R. MOON DC PA
Practice address
1190 Pine Ridge Rd
Suite 1
Naples, FL 34108-8914
Phone
(239) 261-1387
Fax
(239) 263-8780
NPI assigned
Nov 9, 2007
Last updated
Jan 11, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2013

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

Authorized official

Name
Mrs. Wanda Moon
Title
Practice Administrator
Phone
(239) 261-1387

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

1190 Pine Ridge Rd
Suite 1
Naples, FL 34108-8914

Mailing address

1190 Pine Ridge Rd
Suite 1
Naples, FL 34108-8914
Phone (239) 261-1387

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101005000197 FL Part B Supplier - Clinic/Group Practice 9537351994 Receives reassigned benefits from 2 practitioners
Practice locations: Naples, FL

National Provider Directory

National Provider Directory

Locations

1190 Pine Ridge Rd
Ste 1
Naples, FL 34108
Phone (239) 261-1387

1190 Pine Ridge Rd
Naples, FL 34108
Phone (239) 261-1387

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1194566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357862400000",
    "number": "1437339132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1190 PINE RIDGE RD",
            "address_2": "SUITE 1",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341088914",
            "telephone_number": "239-261-1387",
            "fax_number": "239-263-8780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1190 PINE RIDGE RD",
            "address_2": "SUITE 1",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341088914",
            "telephone_number": "239-261-1387",
            "fax_number": "239-263-8780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGE R. MOON DC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-09",
        "last_updated": "2013-01-11",
        "status": "A",
        "authorized_official_last_name": "MOON",
        "authorized_official_first_name": "WANDA",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "239-261-1387",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.