Active NPI
Evan Mooney
- Neurology Physician
- Oklahoma City, OK
National Provider Identifier
1740877851
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 43686
- Practice address
- 920 Stanton L Young Blvd # Wp2040
Oklahoma City, OK 73104-5036 - Phone
- (405) 271-4113
- NPI assigned
- Dec 22, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 43686 | OK | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
920 Stanton L Young Blvd # Wp2040
Oklahoma City, OK 73104-5036
Mailing address
920 Stanton L Young Blvd # Wp2040
Oklahoma City, OK 73104-5036
Phone (405) 271-4113
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 43686 | OK | MD | Neurology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1608595200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718668800000",
"number": "1740877851",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "920 STANTON L YOUNG BLVD # WP2040",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731045036",
"telephone_number": "405-271-4113"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "920 STANTON L YOUNG BLVD # WP2040",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731045036",
"telephone_number": "405-271-4113"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOONEY",
"first_name": "EVAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-12-22",
"last_updated": "2024-06-18",
"certification_date": "2024-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "OK",
"license": "43686",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.