Moonlight Anesthesia Consulting Inc

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

Legal business name

MOONLIGHT ANESTHESIA CONSULTING INC

Practice address

3705 NW 63Rd St
Oklahoma City, OK 73116-1935

Phone

(405) 213-5351

NPI assigned

Apr 26, 2022

Organization subpart

No

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

Authorized official

Name

Traci Wilmarth, CRNA

Title

Crna

Phone

(405) 213-5351

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1650931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650931200000",
    "number": "1669116455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 BELLAIRE DR",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731604206",
            "telephone_number": "405-213-5351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3705 NW 63RD ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731161935",
            "telephone_number": "405-213-5351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOONLIGHT ANESTHESIA CONSULTING INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-26",
        "last_updated": "2022-04-26",
        "certification_date": "2022-04-26",
        "status": "A",
        "authorized_official_last_name": "WILMARTH",
        "authorized_official_first_name": "TRACI",
        "authorized_official_title_or_position": "CRNA",
        "authorized_official_telephone_number": "405-213-5351",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003245481",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Michelle Moon
• Misti Nicole Moon
• Monica Renee Moon
• Evan Mooney
• Richard J Mooney, MD
• Amal E Moorad, M.D.
• Moore Chiropractic PC
• Moore Dentistry & Braces
• Mary Kelly Moore Lackey, LPC
• Moore Restored, Inc

• Anesthesiology Physician in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Anesthesiology Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2022; 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.