Kathryn Kolb Moon, M.S.N., F.N.P-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

200450152NP Issued in OR

Practice address

1900 Woodland Dr
Urology
Coos Bay, OR 97420-2045

Phone

(541) 267-5151

Fax

(541) 266-4574

NPI assigned

Jul 6, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in OR

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

Specialty

Nurse Practitioner

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bay Area Hospital DistrictGroup PAC ID 2163331000, 117 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bay Area Hospital Hospital, Coos Bay, OR, CCN 380090
• Lower Umpqua Hospital District Hospital, Reedsport, OR, CCN 381311

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Bay Area Hospital District

  • General Acute Care Hospital
  • Coos Bay, OR
  • NPI 1225016561
  Medicare reassignment Care Compare group NPD
• North Bend Medical Center Inc

  • Multi-Specialty Clinic/Center
  • Coos Bay, OR
  • NPI 1407812365
  Medicare reassignment NPD
• Bay Area Hospital District

  • Home Health Agency
  • North Bend, OR
  • NPI 1215018197
  NPD
• Feather River Hospital

  • General Acute Care Hospital
  • Paradise, CA
  • NPI 1518940667
  NPD (past)
• Feather River Hospital

  • Oxygen Equipment & Supplies (DME)
  • Chico, CA
  • NPI 1932583622
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bay Area Hospital District

  • General Acute Care Hospital
  • Coos Bay, OR
  • NPI 1225016561
  Care Compare affiliation
• Lower Umpqua Hospital District

  • Critical Access Hospital
  • Reedsport, OR
  • NPI 1003874819
  Care Compare affiliation

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470614400000",
    "number": "1508897778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 WOODLAND DR",
            "address_2": "FAMILY MEDICINE",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202045",
            "telephone_number": "541-267-5151",
            "fax_number": "541-266-4574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 WOODLAND DR",
            "address_2": "UROLOGY",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202045",
            "telephone_number": "541-267-5151",
            "fax_number": "541-266-4574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "KATHRYN",
        "middle_name": "KOLB",
        "credential": "M.S.N., F.N.P-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2016-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "200442251RN",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "200450152NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "292415",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH BEND MEDICAL CENTER GROUP MEDICARE",
            "identifier": "R0000WFBTV",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH BEND MEDICAL CENTER GROUP MEDICAID",
            "identifier": "161133",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH BEND MEDICAL CENTER GROUP TAX ID",
            "identifier": "93-0635514",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH BEND MEDICAL CENTER GROUP NPI",
            "identifier": "1407812365",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA - RAILROAD",
            "identifier": "P01673840",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Monarch Mental Health LLC
• Sharon Elaine Monsivais, M.D.
• David Montes
• Sonimarie H Montgomery
• Leslie Montoro, M.S., SLP
• Mary Lynn Moore, MD
• Gisela Moreland, LCSW
• Joseph T Morgan, M.D.
• Susan Anne Morgan, CNM, FNP
• William James Moriarty, MD

• Family Nurse Practitioner in Coos Bay, OR
• Providers in Coos Bay, OR by specialty
• Family Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.