Active NPI
Jennifer Moon, FNP
- Family Nurse Practitioner
- Live Oak, TX
National Provider Identifier
1639501414
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 789121
- Practice address
- 11465 Toepperwein Rd
Live Oak, TX 78233-3138 - Phone
- (210) 599-9570
- NPI assigned
- Aug 5, 2013
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 789121 | TX | Primary |
Addresses
Primary practice location
11465 Toepperwein Rd
Live Oak, TX 78233-3138
Mailing address
11465 Toepperwein Rd
Live Oak, TX 78233-3138
Phone (210) 599-9570
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 789121 | TX | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Silva Chiropractic PA | Past | Accepting new patients |
Organizations & group practices 1
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": "1375660800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1454025600000",
"number": "1639501414",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11465 TOEPPERWEIN RD",
"city": "LIVE OAK",
"state": "TX",
"postal_code": "782333138",
"telephone_number": "210-599-9570"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11465 TOEPPERWEIN RD",
"city": "LIVE OAK",
"state": "TX",
"postal_code": "782333138",
"telephone_number": "210-599-9570"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOON",
"first_name": "JENNIFER",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-08-05",
"last_updated": "2016-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "TX",
"license": "789121",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Live Oak, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.