Individual provider Active NPI

James Howard Moon, RT

  • Radiography Radiologic Technologist
  • Greenville, SC
National Provider Identifier
1861597569
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiography Radiologic TechnologistTaxonomy code 2471C3402X
License
SCRQSA#00-8504 Issued in SC
Practice address
210 W Stone Ave
Greenville, SC 29609-5452
Phone
(678) 654-1560
NPI assigned
Sep 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiography Radiologic Technologist 2471C3402X SCRQSA#00-8504 SC Primary

Addresses

Primary practice location

210 W Stone Ave
Greenville, SC 29609-5452

Mailing address

PO Box 1718
Cartersville, GA 30120-1679
Phone (678) 654-1560

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SCRQSA#00-8504SCMDRadiography Radiologic Technologist

Practice roles

OrganizationSpecialtyStatusNew patients
Anderson Mobile Imaging,LLC. Past Accepting new patients

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": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861597569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1718",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301201679",
            "telephone_number": "678-654-1560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 W STONE AVE",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296095452",
            "telephone_number": "678-654-1560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "JAMES",
        "middle_name": "HOWARD",
        "credential": "RT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2471C3402X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Radiography",
            "state": "SC",
            "license": "SCRQSA#00-8504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.