Active NPI
John A Moon, LSW
- Social Worker
- Coshocton, OH
National Provider Identifier
1891764940
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- S0010829
- Practice address
- 710 Main St
Coshocton, OH 43812-1615 - Phone
- (740) 454-9766
- Fax
- (740) 588-6452
- NPI assigned
- Mar 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | S0010829 | OH | Primary |
Addresses
Primary practice location
710 Main St
Coshocton, OH 43812-1615
Mailing address
73 E Main St
New Concord, OH 43762-1237
Phone (740) 826-4353
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 318201 | Other | OH | MOUNT CARMEL PIN |
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
| License | State | Type | Specialty |
|---|---|---|---|
| S0010829 | OH | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1891764940",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "73 E MAIN ST",
"city": "NEW CONCORD",
"state": "OH",
"postal_code": "437621237",
"telephone_number": "740-826-4353"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "710 MAIN ST",
"city": "COSHOCTON",
"state": "OH",
"postal_code": "438121615",
"telephone_number": "740-454-9766",
"fax_number": "740-588-6452"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOON",
"first_name": "JOHN",
"middle_name": "A",
"credential": "LSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OH",
"license": "S0010829",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MOUNT CARMEL PIN",
"identifier": "318201",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Coshocton, OH
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.