MARY MICHELLE MOON (NPI# 1144784745) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144784745 |
| Entity Type | Individual |
| Full Name | MARY MICHELLE MOON |
| Practice Address |
4728 Nw 23rd St Apt 4 Oklahoma City OK 73127-2191 |
| Practice Telephone | 4055892100 |
| Mailing Telephone | 4055892100 |
| Enumeration Date | 2019-01-28 |
| Last Update Date | 2019-01-28 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063780484 | Mary Tagish Moon | Doula | 1123 3rd St Sw, Albuquerque, NM 87102-4134 | 2011-12-13 |
| 1124048202 | Mary Yusook Moon | Family Medicine | 23512 Madero, Mission Viejo, CA 92691-2743 | 2006-07-20 |
| Street Address |
4728 NW 23RD ST APT 4 |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73127-2191 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598176711 | We Care LLC | Respite Care | 5400 Nw 23rd Street, Suite 100, Oklahoma City, OK 73127 | 2014-05-09 |
| 1437494655 | Dr. Yong H. Kim, Psyd, Professional Limited Company | Psychologist | 8101 Nw 10th, Oklahoma City, OK 73127 | 2012-11-28 |
| 1952652836 | Kevin Kent Shelton Sr. | Behavioral Analyst | 2120 East Harlow Place, Oklahoma City, OK 73127 | 2012-10-02 |
| 1548537962 | Recovercare LLC | Durable Medical Equipment & Medical Supplies | 6620 Melrose Ln., Oklahoma City, OK 73127 | 2011-11-30 |
| 1326370065 | Karen Lou Gault | Counselor | 7201 N. W. 10th, Okc, OK 73127 | 2010-02-05 |
| 1679708762 | Aerocare Home Medical Equipment, Inc. | Durable Medical Equipment & Medical Supplies | 6125 W Reno Ave Ste 100, Oklahoma City, OK 73127 | 2009-05-19 |
| 1306068432 | Emerald Square Assisted Living, LLC | Assisted Living Facility | 701 North Council Road, Oklahoma City, OK 73127 | 2007-05-02 |
| 1447377585 | Occupational Health Centers of The Southwest, P.a. | Clinic/Center | 6101 West Reno, Suite 800, Oklahoma City, OK 73127 | 2007-03-23 |
| 1811021165 | Carmellia Marie Hamilton | Registered Nurse | 4913 W. Reno, Oklahoma City, OK 73127 | 2007-03-16 |
| 1447345178 | Tim Guinn | Pharmacist | 4911 N.w. 23rd Street, Oklahoma City, OK 73127 | 2006-10-04 |
| Find all providers in zip 73127 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861002818 | Keegan Eisenhardt | Peer Specialist | 6405 S Villa Ave, Oklahoma City, OK 73159-2741 | 2020-08-05 |
| 1689283780 | Gregory Purvis Jr. | Peer Specialist | 1305 Parkwoods Ct, Oklahoma City, OK 73110-7425 | 2020-07-24 |
| 1609485762 | Amanda Elaine Cruz | Peer Specialist | 1605 Nw 30th St Apt 228, Oklahoma City, OK 73118-3622 | 2020-07-24 |
| 1063021384 | Christina Len Petty | Peer Specialist | 2144 Nw 29th St, Oklahoma City, OK 73107-2526 | 2020-07-23 |
| 1104443977 | Jennifer Lynn Cobb | Peer Specialist | 2400 General Pershing Blvd Apt 308, Oklahoma City, OK 73107-6429 | 2020-06-28 |
| 1801412135 | Cleborn Gossett | Peer Specialist | 721 Waterview Rd, Oklahoma City, OK 73170-1637 | 2020-06-23 |
| 1487270617 | Foxy S Starnes | Peer Specialist | 9008 N Shannon Ave, Oklahoma City, OK 73132-1142 | 2020-06-23 |
| 1154945582 | Alexandra Paige Mcgowan-rayburn | Peer Specialist | 4129 Nw 21st St, Oklahoma City, OK 73107-2607 | 2020-06-01 |
| 1962034504 | Crystal Rose Mckee | Peer Specialist | 3417 S Independence Ave, Oklahoma City, OK 73119-2617 | 2020-02-11 |
| 1508496662 | Brie Jordan Florence | Peer Specialist | 2640 Sw 95th St, Oklahoma City, OK 73159-6720 | 2020-01-16 |
| Find all providers in OKLAHOMA CITY | ||||
| City | OKLAHOMA CITY |
| Zip Code | 73127 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.