Individual provider Active NPI

Shannon N. Moonah, M.D.

  • Infectious Disease Physician
  • Gainesville, FL
National Provider Identifier
1821256785
Registry record updated Jul 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
ME162781 Issued in FL
Practice address
1601 S.W. Archer Road
Gainesville, FL 32608
Phone
(352) 548-6000
NPI assigned
May 28, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 010260596 VA
Infectious Disease Physician 207RI0200X ME162781 FL Primary

Addresses

Primary practice location

1601 S.W. Archer Road
Gainesville, FL 32608

Mailing address

1601 S.W. Archer Road
Gainesville, FL 32608-1167

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address smoonah199340@direct.healthsystem.virginia.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME162781FLMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Virginia Physicians Group CurrentSince Aug 3, 2016 Accepting new patients

Locations

1 Hospital Dr
Fl 5
Charlottesville, VA 22908
Phone (434) 982-1414

1300 Jefferson Park Ave
Charlottesville, VA 22903
Phone (434) 924-2241

1215 Lee St
Fl 8
Charlottesvle, VA 22908
Phone (434) 924-2500

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1211932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689724800000",
    "number": "1821256785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 S.W. ARCHER ROAD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326081167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 S.W. ARCHER ROAD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "32608",
            "telephone_number": "352-548-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOONAH",
        "first_name": "SHANNON",
        "middle_name": "N.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-28",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "VA",
            "license": "010260596",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "FL",
            "license": "ME162781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smoonah199340@direct.healthsystem.virginia.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1300 Jefferson Park Ave",
            "city": "Charlottesville",
            "state": "VA",
            "country_code": "US",
            "postal_code": "229033363",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.