Henry S Moon, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

038311 Issued in GA

Practice address

2098 Teron Trce
Ste150
Dacula, GA 30019-1662

Phone

(678) 730-1620

Fax

(678) 730-0858

NPI assigned

Apr 4, 2006

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

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Medical College of Georgia School of Medicine, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Reagan Medical Center LLCGroup PAC ID 6507779329, 16 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northside Hospital Gwinnett Hospital, Lawrenceville, GA, CCN 110087

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Reagan Medical Center LLC

  • Family Medicine Physician
  • Suwanee, GA
  • NPI 1952316747
  Medicare reassignment Care Compare group
• Gwinnett Physician Group, LLC

  • Internal Medicine Physician
  • Lawrenceville, GA
  • NPI 1578574661

  Family Medicine

  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Northside Hospital, Inc.

  dba Northside Hospital Gwinnett

  • General Acute Care Hospital
  • Lawrenceville, GA
  • NPI 1952340994
  Care Compare affiliation

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

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263513600000",
    "number": "1780646083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2098 TERON TRACE",
            "address_2": "STE150",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300191662",
            "telephone_number": "678-730-1620",
            "fax_number": "678-730-0858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2098 TERON TRCE",
            "address_2": "STE150",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300191662",
            "telephone_number": "678-730-1620",
            "fax_number": "678-730-0858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "HENRY",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-04",
        "last_updated": "2010-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "038311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jahvez Mitchell, RN
• Ashley Moates
• Mohmedali Hasmatali Momin, FNP
• Colleen Aletha Montaque
• Julie E Moody, SLP
• Moore Speech & Language LLC
• Molly Moore, CCC-SLP
• Kristen Doolittle Moran, PT, DPT
• Rose Morlino, PHD, BCBA
• Kimberly Morris

• Family Medicine Physician in Dacula, GA
• Providers in Dacula, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.