NPIMap

Organization Active NPI

Moon Eye Clinic, P.a.

  • Optometrist
  • Heber Springs, AR
National Provider Identifier
1871670620
Registry record updated Apr 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2250 Issued in AR
Legal business name
MOON EYE CLINIC, P.A.
Practice address
509 N 2ND St
Heber Springs, AR 72543-2513
Phone
(501) 362-8191
Fax
(501) 362-3096
NPI assigned
Nov 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2008

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

Authorized official

Name
Dr. Jerry Alan Moon, O.D.
Title
Optometric Physician
Phone
(501) 362-8191

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 2250 AR Primary

Addresses

Primary practice location

509 N 2ND St
Heber Springs, AR 72543-2513

Mailing address

PO Box 2
Heber Springs, AR 72543-0002
Phone (501) 362-8191

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208390400000",
    "number": "1871670620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2",
            "city": "HEBER SPRINGS",
            "state": "AR",
            "postal_code": "725430002",
            "telephone_number": "501-362-8191",
            "fax_number": "501-362-3096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 N 2ND ST",
            "city": "HEBER SPRINGS",
            "state": "AR",
            "postal_code": "725432513",
            "telephone_number": "501-362-8191",
            "fax_number": "501-362-3096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOON EYE CLINIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2008-04-17",
        "status": "A",
        "authorized_official_last_name": "MOON",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "OPTOMETRIC PHYSICIAN",
        "authorized_official_telephone_number": "501-362-8191",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Heber Springs, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2008; 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.