Active NPI
Elizabeth Carolyn Moon, OTR
- Occupational Therapist
- Dallas, TX
National Provider Identifier
1902072051
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 109677
- Practice address
- 8050 Meadow Rd
Dallas, TX 75231-3406 - Phone
- (469) 232-6500
- NPI assigned
- May 7, 2008
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 109677 | TX | Primary |
Addresses
Primary practice location
8050 Meadow Rd
Dallas, TX 75231-3406
Mailing address
411 Mayrant Dr
Dallas, TX 75224-1419
Phone (214) 876-2804
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 |
|---|---|---|---|
| 109677 | TX | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mentis Management Services, 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.
-
- Pediatric Occupational Therapist
- Dallas, TX
- NPI 1780270223
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1738713600000",
"number": "1902072051",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "411 MAYRANT DR",
"city": "DALLAS",
"state": "TX",
"postal_code": "752241419",
"telephone_number": "214-876-2804"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8050 MEADOW RD",
"city": "DALLAS",
"state": "TX",
"postal_code": "752313406",
"telephone_number": "469-232-6500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOON",
"first_name": "ELIZABETH",
"middle_name": "CAROLYN",
"name_prefix": "Ms.",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-07",
"last_updated": "2025-02-05",
"certification_date": "2025-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TX",
"license": "109677",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.