Active NPI
Stephanie A Moon
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Crozet, VA
National Provider Identifier
1497199541
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Practice address
- 1675 Buck Rd
Crozet, VA 22932-2720 - Phone
- (434) 205-4333
- Fax
- (434) 205-4016
- NPI assigned
- Apr 19, 2013
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 320900000X | Primary |
Addresses
Primary practice location
1675 Buck Rd
Crozet, VA 22932-2720
Mailing address
1675 Buck Rd
Crozet, VA 22932-2720
Phone (434) 205-4333
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 274236485 | Other | VA | FEDERAL I D |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1366329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1366329600000",
"number": "1497199541",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1675 BUCK RD",
"city": "CROZET",
"state": "VA",
"postal_code": "229322720",
"telephone_number": "434-205-4333",
"fax_number": "434-205-4016"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1675 BUCK RD",
"city": "CROZET",
"state": "VA",
"postal_code": "229322720",
"telephone_number": "434-205-4333",
"fax_number": "434-205-4016"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOON",
"first_name": "STEPHANIE",
"middle_name": "A",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-04-19",
"last_updated": "2013-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "320900000X",
"taxonomy_group": "",
"desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FEDERAL I D",
"identifier": "274236485",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Crozet, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.