Moon Family & Behavioral Health LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MOON FAMILY & BEHAVIORAL HEALTH LLC

Practice address

161 Clint Dr Ste 200
Pickerington, OH 43147-7794

Phone

(614) 705-6161

Fax

(614) 705-6151

NPI assigned

Jan 31, 2023

Last updated

Jan 31, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Brian Dean

Title

Admin

Phone

(614) 706-5206

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mamadou Saliou Diallo, DNP, FNP-BC,PMHNP-BC

  • Family Nurse Practitioner
  • Pickerington, OH
  • NPI 1922594746
  Medicare reassignment NPD
• Ebrima Jatta, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Everett, WA
  • NPI 1205134210

  OH

  Medicare reassignment NPD

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

{
    "created_epoch": "1675123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675123200000",
    "number": "1902512122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 CLINT DR STE 200",
            "city": "PICKERINGTON",
            "state": "OH",
            "postal_code": "431477794",
            "telephone_number": "614-705-6161",
            "fax_number": "614-705-6151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 CLINT DR STE 200",
            "city": "PICKERINGTON",
            "state": "OH",
            "postal_code": "431477794",
            "telephone_number": "614-705-6161",
            "fax_number": "614-705-6151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOON FAMILY & BEHAVIORAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-31",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-31",
        "status": "A",
        "authorized_official_last_name": "DEAN",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "ADMIN",
        "authorized_official_telephone_number": "614-706-5206"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sonya Renee Moesle, DDS
• Maryam Omotomelewa Mohammed-Norgan
• Kristen Mohler
• Amanda Monaghan, RN
• Kathy Montgomery
• Colette Moon
• Melissa Shigeyo Moon, CNP
• Ryan Danae Moore-Rose
• Airreanna Laylee Moore
• Anne Moore

• Family Medicine Physician in Pickerington, OH
• Providers in Pickerington, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.