Moonlight Diagnostics LLC

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

Legal business name

MOONLIGHT DIAGNOSTICS LLC

Practice address

3188 Parliament Cir Ste 802
Montgomery, AL 36116-7271

Phone

(334) 416-8298

Fax

(833) 260-4473

NPI assigned

Feb 10, 2019

Organization subpart

No

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

Authorized official

Name

Gregory R Lipscomb, MDNPI 1427218114

Title

President

Phone

(251) 554-7798

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gregory Robin Lipscomb, M.D.

  • Neurology Physician
  • Montgomery, AL
  • NPI 1427218114
  Medicare reassignment Care Compare group Authorized official
• Amanda Dease Hargrove, CRNP

  • Nurse Practitioner
  • Montgomery, AL
  • NPI 1568895589
  Medicare reassignment Care Compare group NPD
• Caroline Brawley Johnson, MS, RDN, LD

  • Registered Dietitian
  • Montgomery, AL
  • NPI 1811688419
  Medicare reassignment NPD
• Angela B. McCormick, MS,RD,LD

  • Registered Dietitian
  • Montgomery, AL
  • NPI 1346137569

  Single Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1549756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559520000000",
    "number": "1801351291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3188 PARLIAMENT CIR STE 802",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361167271",
            "telephone_number": "334-416-8298",
            "fax_number": "833-260-4473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3188 PARLIAMENT CIR STE 802",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361167271",
            "telephone_number": "334-416-8298",
            "fax_number": "833-260-4473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOONLIGHT DIAGNOSTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-10",
        "last_updated": "2019-06-03",
        "status": "A",
        "authorized_official_last_name": "LIPSCOMB",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "251-554-7798",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronald Kent Montgomery, M.D.
• David C Montiel, MD
• Jessica Lynn Moody, CRNP
• Robert H Moon, MD
• Moon's Acupuncture
• Kenya L Moore Dixon, ALC
• Moore Healing LLC
• Cassandra Moore, LPC
• Chavona Prinshay Moore, CRNP
• Daniel L Moore, MD

• Neurology Physician in Montgomery, AL
• Providers in Montgomery, AL by specialty
• Neurology Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.