Crystal Elaine Moon, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

2666 Issued in TN

Practice address

961 Spring Creek Rd Ste 300
Chattanooga, TN 37412

Phone

(423) 893-9787

NPI assigned

Dec 4, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Allcare Ga PCGroup PAC ID 2668907940, 36 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: crystal.moon.1@33029.direct.athenahealth.com
• Direct secure messaging: crystal.lawson@hca1.eclinicaldirectplus.com

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.

• Allcare Ga PC

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1972080554
  Medicare reassignment Care Compare group
• Orthosports1St Ga

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Kennesaw, GA
  • NPI 1326844689
  Medicare reassignment
• Peachtree Immediate Care FP, LLC

  • Family Medicine Physician
  • Hiram, GA
  • NPI 1437194156
  Medicare reassignment
• Capital Healthcare PC

  • Primary Care Clinic/Center
  • Alexandria, VA
  • NPI 1811239627
  NPD (past)

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

{
    "created_epoch": "1417651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528934400000",
    "number": "1912304015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 PAUL HUFF PARKWAY NW",
            "address_2": "SUITE 105",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "37312",
            "telephone_number": "423-790-4420",
            "fax_number": "423-790-7750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "961 SPRING CREEK RD STE 300",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "37412",
            "telephone_number": "423-893-9787"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "645 Paul Huff Parkway NW",
            "address_2": "Suite 105",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "TN",
            "postal_code": "37312",
            "country_code": "US",
            "telephone_number": "423-790-4420",
            "fax_number": "423-790-7750",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOON",
        "first_name": "CRYSTAL",
        "middle_name": "ELAINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-04",
        "last_updated": "2018-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TN",
            "license": "2666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Elaine Montilla
• Monty S. Riley, O.D., P.C.
• Bonnie P Moody, LCSW
• Gina Moody, RN
• Richard D.L. Moody, MD
• Kristen Moon
• Shareka Dion Moon, RN
• Abigail Tipton Moore
• Amy Moriah Moore, RN
• Amy N Moore, DOCTOR OF P.T.

• Medical Physician Assistant in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Medical Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.