Steven Allen Moon Jr., DNP

Primary specialty

Ambulatory Care Registered NurseTaxonomy code 163WP2201X

License

227981 Issued in GA

Practice address

5095 Mount Zion Pkwy
Stockbridge, GA 30281-7825

Phone

(770) 507-0576

NPI assigned

Oct 25, 2021

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1635120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635120000000",
    "number": "1760146864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 RIVER COVE RD",
            "city": "SOCIAL CIRCLE",
            "state": "GA",
            "postal_code": "300254873",
            "telephone_number": "678-449-9047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5095 MOUNT ZION PKWY",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817825",
            "telephone_number": "770-507-0576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "STEVEN",
        "middle_name": "ALLEN",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-25",
        "last_updated": "2021-10-25",
        "certification_date": "2021-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP2201X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "GA",
            "license": "227981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justin Lee Monsrud, PT
• Saunsarae Montanez-Simmons, P.T.
• Carla Montfort
• Sheree C. Montgomery, PT, DPT
• Shamara Moody, LPC, DCC
• Breauna Moore, RN
• Candace Renata Moore, CCC,SLP
• Jacinta L Moore, NP
• Mackenzie Moore
• Tyleka Moore

• Ambulatory Care Registered Nurse in Stockbridge, GA
• Providers in Stockbridge, GA by specialty
• Ambulatory Care Registered Nurse in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2021; 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.