JORDAN EDWARD MOON (NPI# 1770031221) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1770031221 |
Entity Type | Individual |
Full Name | JORDAN EDWARD MOON |
Credential | PA-C, MPH |
Practice Address |
2280 Marcola Rd Springfield OR 97477-2594 |
Practice Telephone | 5417474300 |
Practice Fax Number | 5417470655 |
Mailing Telephone | 5417474300 |
Mailing Fax Number | 5417470655 |
Enumeration Date | 2016-09-13 |
Last Update Date | 2016-09-13 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA179905 | OR | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
2280 MARCOLA RD |
City | SPRINGFIELD |
State | OR |
Zip Code | 97477-2594 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1154320380 | Michael Stan Findley | Family Medicine | 2280 Marcola Rd, Springfield, OR 97477-2594 | 2005-07-19 |
1700483518 | Peter Randall Hill | Physician Assistant | 2280 Marcola Rd, Springfield, OR 97477-2594 | 2020-10-05 |
1871106914 | Viet Quoc Nguyen | Pharmacist | 2280 Marcola Rd, Springfield, OR 97477-2594 | 2020-08-28 |
1417567082 | Willem Poelmans | Physician Assistant | 2280 Marcola Rd, Springfield, OR 97477-2594 | 2020-08-07 |
1528605086 | Reed Casey Janke | Family Medicine | 2280 Marcola Rd, Springfield, OR 97477-2594 | 2019-12-04 |
1780230284 | April Noelle Tharp | Family Medicine | 2280 Marcola Rd, Springfield, OR 97477-2594 | 2019-08-12 |
1205481801 | Ashley Lynne Johns | Physician Assistant | 2280 Marcola Rd, Springfield, OR 97477-2594 | 2019-08-09 |
1376009282 | Wendy Renee Hounsel | Nurse Practitioner | 2280 Marcola Rd, Springfield, OR 97477-2594 | 2019-02-15 |
1952890402 | Jonathan David Duke | Pharmacist | 2280 Marcola Rd, Springfield, OR 97477-2594 | 2018-05-09 |
1003340613 | Alejandro Elliott Colmenero I | Physician Assistant | 2280 Marcola Rd, Springfield, OR 97477-2594 | 2017-04-20 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1508416140 | Chase Michael Collings | Physician Assistant | 960 N 16th St Ste 303, Springfield, OR 97477 | 2019-09-16 |
1174079396 | Amie Flanagan | Occupational Therapy Assistant | 3152 Valentine Court, Springfield, OR 97477 | 2016-08-28 |
1609229590 | Kiernan Davis Snedigar | Counselor | 175 W B St Ste J, Springfield, OR 97477 | 2016-07-15 |
1578914206 | Ryan James Dixon | Counselor | 1923 Centennial Blvd, Springfield, OR 97477 | 2016-06-23 |
1902275464 | Jovonnie Bashaw | Counselor | 1157 5th St, Springfield, OR 97477 | 2015-09-15 |
1053759506 | Norco Inc | Durable Medical Equipment & Medical Supplies | 302 Shelley St Ste 7&8, Springfield, OR 97477 | 2013-06-06 |
1780931634 | Justin Morris | Pharmacist | 1891 Pioneer Parkway East, Springfield, OR 97477 | 2012-08-09 |
1194083105 | Mersedeh Bahr Hosseini | Psychiatry & Neurology | 3311 Riverbend Dr., Neurohospitalists, Springfield, OR 97477 | 2012-04-26 |
1962769679 | Hiro Kawata | Internal Medicine | 3311 Rierbend Dr., Springfield, OR 97477 | 2012-04-19 |
1659662823 | Wendy A Teigen | Counselor | 3995 Marcola Rd., Springfield, OR 97477 | 2011-04-22 |
Find all providers in zip 97477 |
Taxonomy Code | 363AM0700X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Medical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1871122168 | Alexandra Emmanuelle Rochman | Physician Assistant | 54 W Crystal Brook Dr, Springfield, MA 01118-1946 | 2020-04-07 |
1740740737 | Western New England University | Physician Assistant | 215 Wilbraham Road, Springfield, MA 01119 | 2019-03-25 |
1033462387 | Miguel Angel Medina | Physician Assistant | 1900 South Sunshine Ave., Springfield, MO 65807 | 2012-10-24 |
1770850216 | Lauren Jennifer Navas | Physician Assistant | 100 River St Ste 2, Springfield, VT 05156-2930 | 2011-11-29 |
1295885168 | Jacqueline Kernaghan | Physician Assistant | 723 Saxer Ave, Springfield, PA 19064-3503 | 2007-01-11 |
1295746733 | Gwen Wright | Physician Assistant | 194 W Sproul Rd, Suite 105, Springfield, PA 19064-2027 | 2006-08-10 |
1164490710 | Stacie L Pierce | Physician Assistant | 3721 W El Castile St, Springfield, MO 65807-5431 | 2006-03-09 |
1245206432 | Annette K Bates | Physician Assistant | 819 Worcester St Ste 3, Springfield, MA 01151-1056 | 2006-02-27 |
1518947159 | Louis Patrick Favata | Physician Assistant | 140 High St., Springfield, MA 01199 | 2006-01-19 |
1649257031 | Scott D Rubin | Physician Assistant | 3400 Main Street, Springfield, MA 01107-1113 | 2005-12-27 |
Find all providers in SPRINGFIELD |
City | SPRINGFIELD |
Zip Code | 97477 |
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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.