Megan Elizabeth Moon, RD, LDN

Primary specialty

Metabolic Nutrition Registered DietitianTaxonomy code 133VN1006X

License

164005000 Issued in IL

Practice address

1415 Vermont St
Quincy, IL 62301-3119

Phone

(217) 223-8400

Fax

(217) 223-9716

NPI assigned

Dec 31, 2009

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

Other names 1

• Mrs. Megan Elizabeth Smiddy Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1262217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288742400000",
    "number": "1811227549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 1/2 BROADWAY ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623012835",
            "telephone_number": "217-223-8400",
            "fax_number": "217-223-9716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 VERMONT ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623013119",
            "telephone_number": "217-223-8400",
            "fax_number": "217-223-9716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "MEGAN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "RD, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-31",
        "last_updated": "2010-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "IL",
            "license": "164005000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEGAN",
            "last_name": "SMIDDY",
            "middle_name": "ELIZABETH",
            "prefix": "MRS.",
            "credential": "RD LDN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Laudoria B Montgomery
• Terry Montgomery, PTA
• Monty P Karoll, MD PC
• Moon Dental LLC
• Kara C Moon, MSW, LSW
• Briana Moore
• Brittney Moore, PHD
• Chase Moore, PHARMD
• Christopher Hudson Moore, M.D.
• Daniel L Moore, M.D.

• Metabolic Nutrition Registered Dietitian in Quincy, IL
• Providers in Quincy, IL by specialty
• Metabolic Nutrition Registered Dietitian in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2010; 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.