Individual provider Active NPI

Emily Moon, CRNA

  • Certified Registered Nurse Anesthetist
  • Winston Salem, NC
National Provider Identifier
1447775119
Registry record updated May 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APN.0995314-CRNA Issued in CO
Practice address
145 Kimel Park Dr
Suite 120
Winston Salem, NC 27103
Phone
(336) 768-3212
Fax
(336) 768-9019
NPI assigned
Aug 3, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 273312 NC
Certified Registered Nurse Anesthetist 367500000X APN.0995314-CRNA CO Primary

Addresses

Primary practice location

145 Kimel Park Dr
Suite 120
Winston Salem, NC 27103

Mailing address

PO Box 110429
Aurora, CO 80042-0429

Other practice location 1

12605 E 16th Ave
Aurora, CO 80045-2545
Phone (720) 848-0000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200116002522 CO Practitioner - Certified Registered Nurse Anesthetist (Crna) 4880960426 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Colorado Crna Associates IncGroup PAC ID 3072785559, 3 clinicians

Practice addresses (Care Compare)

7353 Sisters GRV
Colorado Springs, CO 80923-2615
Phone (719) 444-8484

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
APN.0995314-CRNACOMDCertified Registered Nurse Anesthetist
273312NCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Peak Gastroenterology Associates CurrentSince Dec 4, 2022 Accepting new patients
Southern Colorado Crna Associates Inc Nurse Anesthetist, Certified Registered CurrentSince Jan 26, 2023 Accepting new patients
Arapahoe Gastroenterology Anesthesia Associates LLC Anesthesiology CurrentSince Oct 20, 2022 Accepting new patients
US Anesthesia Partners of Colorado Inc. Anesthesiology CurrentSince Dec 6, 2019 Accepting new patients
Anesthesia Dynamics LLC Anesthesiology CurrentSince Oct 1, 2022 Accepting new patients
University Physicians, Incorporated Past Accepting new patients
University Physicians Incorporated Anesthesiology Past Accepting new patients

Locations

12605 E 16th Ave
#B113
Aurora, CO 80045
Phone (720) 848-4000

12605 E 16th Ave
Aurora, CO 80045
Phone (720) 848-0006

13123 E 16th Ave
Aurora, CO 80045
Phone (720) 777-3846

1370 Interquest Pkwy
Ste 320
Colorado Springs, CO 80921

7353 Sisters Grv
Colorado Springs, CO 80923
Phone (719) 355-1001

2920 N Cascade Ave
#P
Colorado Springs, CO 80907

2222 N Nevada Ave
Colorado Springs, CO 80907
Phone (719) 776-5333

2920 N Cascade Ave
Ste 300
Colorado Springs, CO 80907

2920 N Cascade Ave
Colorado Springs, CO 80907
Phone (719) 636-3937

1615 Medical Center Pt
Colorado Springs, CO 80907
Phone (719) 635-7740

2920 N Cascade Ave
Fl 1
Colorado Springs, CO 80907
Phone (719) 362-2300

1001 Southpark Dr
Littleton, CO 80120
Phone (303) 531-5724

10101 Ridgegate Pkwy
Lone Tree, CO 80124
Phone (720) 225-1000

400 10th St E
Waconia, MN 55387

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1501718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684108800000",
    "number": "1447775119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110429",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800420429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 KIMEL PARK DR",
            "address_2": "SUITE 120",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "27103",
            "telephone_number": "336-768-3212",
            "fax_number": "336-768-9019"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12605 E 16th Ave",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800452545",
            "country_code": "US",
            "telephone_number": "720-848-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOON",
        "first_name": "EMILY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-03",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "273312",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CO",
            "license": "APN.0995314-CRNA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.