Shirley A Moon, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

148589M-IV Issued in OH

Practice address

601 S Edwin C Moses Blvd
Dayton, OH 45417-3424

Phone

(937) 734-8333

Fax

(937) 716-1331

NPI assigned

Apr 3, 2017

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

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": "1491177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523836800000",
    "number": "1801328372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 S EDWIN MOSES BLVD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454173424",
            "telephone_number": "937-734-8333",
            "fax_number": "937-716-1331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 S EDWIN C MOSES BLVD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454173424",
            "telephone_number": "937-734-8333",
            "fax_number": "937-716-1331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "SHIRLEY",
        "middle_name": "A",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-03",
        "last_updated": "2018-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "148589M-IV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mariela Monzalvo
• Tessa Marie-Ann Moody
• Vicky L Moody, DO
• Vivian K Moody
• Da'Shelle Moon
• Connor Deacon Mooney, MD
• Moore Chiropractic Clinic, Inc.
• Moore Chiropractic Family Wellness, Inc.
• Christina Moore-Easley, DENTAL ASSISTANT
• Sonya Maria Moore-Williams, HOME HEALTH AID

• Licensed Practical Nurse in Dayton, OH
• Providers in Dayton, OH by specialty
• Licensed Practical Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2018; 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.