Individual provider Active NPI

Scott A Moon, D.C.

  • Chiropractor
  • Kingman, AZ
National Provider Identifier
1801841341
Registry record updated May 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5153 Issued in AZ
Practice address
1751 N Stockton Hill Rd
Suite B
Kingman, AZ 86401-6601
Phone
(928) 753-1120
Fax
(928) 753-6191
NPI assigned
May 23, 2006
Last updated
May 3, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5153 AZ Primary

Addresses

Primary practice location

1751 N Stockton Hill Rd
Suite B
Kingman, AZ 86401-6601

Mailing address

1751 Stockton Hill Road
Suite B
Kingman, AZ 86401-6601
Phone (928) 753-1120

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041004000263 AZ Practitioner - Chiropractic 7810956109 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1751 N Stockton Hill Rd
Suite B
Kingman, AZ 86401-6601
Phone (928) 753-1120

1751 N Stockton Hill Rd B
Kingman, AZ 86401-6601

1751 Stockton Hill Rd
Suite B
Kingman, AZ 86401-6601

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5153AZMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Moon Chiropractic Center, PLLC Chiropractor CurrentSince Apr 1, 2008 Accepting new patients

Locations

1751 N Stockton Hill Rd
Ste B
Kingman, AZ 86401
Phone (928) 715-9258

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336003200000",
    "number": "1801841341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1751 STOCKTON HILL ROAD",
            "address_2": "SUITE B",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864016601",
            "telephone_number": "928-753-1120",
            "fax_number": "928-753-6191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1751 N STOCKTON HILL RD",
            "address_2": "SUITE B",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864016601",
            "telephone_number": "928-753-1120",
            "fax_number": "928-753-6191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "SCOTT",
        "middle_name": "A",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-23",
        "last_updated": "2012-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "5153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingman, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.