Dr.Moonwalk, Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

DR.MOONWALK, INC

Practice address

270 Center Dr
Suite 120
Vernon Hills, IL 60061-1564

Phone

(888) 592-9255

Fax

(888) 467-4681

NPI assigned

Jun 8, 2010

Last updated

Jan 20, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jung H Moon, DPM

Title

President

Phone

(888) 592-9255

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1275955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327017600000",
    "number": "1760702195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 CENTER DR",
            "address_2": "SUITE 120",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600611564",
            "telephone_number": "888-592-9255",
            "fax_number": "888-467-4681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 CENTER DR",
            "address_2": "SUITE 120",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600611564",
            "telephone_number": "888-592-9255",
            "fax_number": "888-467-4681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR.MOONWALK, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-08",
        "last_updated": "2012-01-20",
        "status": "A",
        "authorized_official_last_name": "MOON",
        "authorized_official_first_name": "JUNG",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "888-592-9255",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2012; 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.