Half Moon Medical Associates, PLLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

8466 Issued in NC

Legal business name

HALF MOON MEDICAL ASSOCIATES, PLLC

Practice address

19701 W Catawba Ave
Suite F
Cornelius, NC 28031-4080

Phone

(704) 895-7819

Fax

(704) 896-7819

NPI assigned

Jun 8, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Gregory Moon, NCC, LPC, LCASNPI 1871859603

Title

Clinical Director

Phone

(704) 989-1031

Specialties & licenses 5

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gregory A Moon, MA, NCC, LCAS, LPC

  • Addiction (Substance Use Disorder) Counselor
  • Cornelius, NC
  • NPI 1871859603
  NPD (past) Authorized official
• Jana Kaye Burson, M.D.

  • Addiction Medicine (Preventive Medicine) Physician
  • Cornelius, NC
  • NPI 1790811982
  NPD (past)

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

{
    "created_epoch": "1402185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402185600000",
    "number": "1558774422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19701 W CATAWBA AVE",
            "address_2": "SUITE F",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280314080",
            "telephone_number": "704-895-7819",
            "fax_number": "704-896-7819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19701 W CATAWBA AVE",
            "address_2": "SUITE F",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280314080",
            "telephone_number": "704-895-7819",
            "fax_number": "704-896-7819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HALF MOON MEDICAL ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-08",
        "last_updated": "2014-06-08",
        "status": "A",
        "authorized_official_last_name": "MOON",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "704-989-1031",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "NCC, LPC, LCAS"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "3337",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "8466",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "8466",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "39164",
            "primary": false
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "NC",
            "license": "39164",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Cornelius, NC
• Providers in Cornelius, NC by specialty
• Professional Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2014; 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.