Jodi Rae Moon, R.D., C.D.E

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

674 Issued in OR

Practice address

519 15TH St
Oregon City, OR 97045-1448

Phone

(503) 650-6822

Fax

(503) 650-6876

NPI assigned

May 17, 2010

Last updated

May 17, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Providence Health and Services OregonGroup PAC ID 5294623245, 166 clinicians

Providence Health and Services OregonGroup PAC ID 0648183608, 1,423 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Providence Health & Services Oregon

  dba Providence Medical Group

  • General Practice Physician
  • Lake Oswego, OR
  • NPI 1023488343
  Medicare reassignment Care Compare group NPD
• Providence Health & Services Oregon

  dba Providence Medical Group South

  • Family Medicine Physician
  • Medford, OR
  • NPI 1568547503
  Medicare reassignment Care Compare group NPD
• Providence Health & Services - Oregon

  dba Providence Medical Group

  • Family Medicine Physician
  • Gresham, OR
  • NPI 1053419218
  NPD
• Providence Health & Services - Oregon

  dba Providence Medical Group

  • Clinic/Center
  • Newberg, OR
  • NPI 1356411342
  NPD
• Providence Health & Services - Oregon

  dba PMG South Pulmonology

  • Family Medicine Physician
  • Medford, OR
  • NPI 1437469087
  NPD
• Providence Health & Services - Oregon

  dba Providence Medical Group South

  • Clinic/Center
  • Phoenix, OR
  • NPI 1992882500
  NPD
• Providence Health & Services Oregon

  dba Providence Medical Group

  • Psychiatry Physician
  • Portland, OR
  • NPI 1760177737
  NPD

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

{
    "created_epoch": "1274054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274054400000",
    "number": "1679891501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "519 15TH ST",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970451448",
            "telephone_number": "503-650-6822",
            "fax_number": "503-650-6876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519 15TH ST",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970451448",
            "telephone_number": "503-650-6822",
            "fax_number": "503-650-6876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "JODI",
        "middle_name": "RAE",
        "credential": "R.D., C.D.E",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-17",
        "last_updated": "2010-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OR",
            "license": "674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nanea Ikeahonuiokamaile Moke-Rabang
• Tessa J Molter, PAC
• Linda M Monk, LMFT
• Dana R Moody, RDH, BS
• Jennifer Moon, NP
• Katie Marika Moon
• Amanda Moore-Witter
• Alexa Moore
• Andrew Moore
• Raquel P Moore, PA-C

• Registered Dietitian in Oregon City, OR
• Providers in Oregon City, OR by specialty
• Registered Dietitian in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.