HENRY S MOON (NPI# 1780646083) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780646083 |
| Entity Type | Individual |
| Full Name | HENRY S MOON |
| Credential | MD |
| Practice Address |
2098 Teron Trce Ste150 Dacula GA 30019-1662 |
| Mailing Address |
2098 Teron Trace Ste150 Dacula GA 30019-1662 |
| Practice Telephone | 6787301620 |
| Practice Fax Number | 6787300858 |
| Mailing Telephone | 6787301620 |
| Mailing Fax Number | 6787300858 |
| Enumeration Date | 2006-04-04 |
| Last Update Date | 2010-01-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 038311 | GA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578648234 | Henry B. Moon | Internal Medicine | 39400 Paseo Padre Pkwy, Fremont, CA 94538-2310 | 2006-10-25 |
| 1174586754 | Henry W Moon | Obstetrics & Gynecology | 1000 Houghton Ave, Saginaw, MI 48602-5303 | 2006-04-06 |
| Street Address |
2098 TERON TRCE STE150 |
| City | DACULA |
| State | GA |
| Zip Code | 30019-1662 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346595204 | Covenant Family Medicine Gmg LLC | Family Medicine | 2098 Teron Trce, Suite 150, Dacula, GA 30019-1663 | 2012-07-17 |
| 1568691046 | Choices Gwinnett, LLC | Community/Behavioral Health | 2098 Teron Trce, Suite 300, Dacula, GA 30019-1663 | 2009-07-06 |
| 1073786281 | Sleep Services of America | Clinical Medical Laboratory | 2098 Teron Trce, Suite 400, Dacula, GA 30019-1663 | 2008-04-09 |
| 1669653002 | North Gwinnett Primary Care | Clinic/Center | 2098 Teron Trce, Dacula, GA 30019-1663 | 2007-11-14 |
| 1659551091 | Cornerstone Family Practice, P.C. | Specialist | 2098 Teron Trce, Suite 400, Dacula, GA 30019-1663 | 2007-11-13 |
| 1295959880 | Hamilton Mill Medical & Physical Therapy | Preventive Medicine | 2098 Teron Trce, Ste 300, Dacula, GA 30019-1662 | 2007-04-13 |
| 1417091471 | Benjamin Caughey Mitchell | Chiropractor | 2098 Teron Trce, Ste 300, Dacula, GA 30019-1667 | 2007-02-16 |
| 1134262777 | George Quintero | Dentist | 2098 Teron Trce, Suite 600, Dacula, GA 30019-1662 | 2007-02-14 |
| 1851353098 | Rene Latoni | Family Medicine | 2098 Teron Trce, Ste150, Dacula, GA 30019-1662 | 2006-04-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780228171 | Mackenson Lafortune | Physical Therapy Assistant | 1424 Filigree Pl, Dacula, GA 30019 | 2019-10-29 |
| 1780167452 | Adenike Alaga | Registered Nurse | 3196 Dolostone Way, Dacula, GA 30019 | 2018-09-10 |
| 1780160580 | Cielitha Ruffin | Nurse Practitioner | 1223 Bentley Estates Dr., Dacula, GA 30019 | 2018-07-15 |
| 1386135663 | Anke Mbapeh | Nurse Practitioner | 2100 Browning Bend Ct, Dacula, GA 30019 | 2018-05-23 |
| 1053820282 | Ethan Zachariah Merrow | Student in an Organized Health Care Education/Training Program | 1701 Mulberry Lake Drive, Dacula, GA 30019 | 2017-09-20 |
| 1043737547 | Dawn Hedley | Dietitian, Registered | 3567 Vern Way, Dacula, GA 30019 | 2017-08-25 |
| 1831545367 | Angela Owusu-edusei | Nurse Practitioner | 3226 Dolostone Way, Dacula, GA 30019 | 2016-05-13 |
| 1528458718 | Philomena Gyamfi | Registered Nurse | 1088 Milford Ln, Dacula, GA 30019 | 2015-01-27 |
| 1417375247 | Casey Goldman Sommerfeld | Pediatrics | 2240 Hamilton Creek Pkwy Ste 600, Dacula, GA 30019 | 2014-03-29 |
| 1417398215 | Samia Tahil | Home Health | 2821 Spence Ct, Dacula, GA 30019 | 2013-07-10 |
| Find all providers in zip 30019 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730665365 | Livewell Health Services | Family Medicine | 1250b Auburn Rd Ste 202, Dacula, GA 30019-5433 | 2018-07-17 |
| 1558578211 | Edward R Bailey | Family Medicine | 1840 Ridgemill Ter, Dacula, GA 30019-2955 | 2007-05-16 |
| 1962532085 | Covenant Family Medicine | Family Medicine | 2098 Teron Trace Suite 150, Dacula, GA 30019 | 2007-03-07 |
| 1639182132 | Anthony F Human | Family Medicine | 1250b Auburn Rd, Suite 201, Dacula, GA 30019-5432 | 2006-08-14 |
| 1760490742 | Dacula Family Practice Inc | Family Medicine | 2850 Hog Mountain Rd, Suite 102, Dacula, GA 30019 | 2006-08-04 |
| 1386690923 | Minkailu Sesay | Family Medicine | 852 Dacula Rd, Dacula, GA 30019-3185 | 2006-05-25 |
| 1730185596 | Ronald L Hart | Family Medicine | 3685 Braselton Hwy, Suite 100, Dacula, GA 30019-5920 | 2005-06-24 |
| 1154803245 | Human Health Services | Family Medicine | 1250b Auburn Rd Ste 202, Dacula, GA 30019-5433 | 2018-09-05 |
| 1184079196 | Jennifer B. Cobernus | Family Medicine | 852 Dacula Rd, Dacula, GA 30019 | 2016-04-27 |
| 1295199677 | Elvira Jasarevic | Family Medicine | 3575 Braselton Hwy, Dacula, GA 30019-1027 | 2016-04-11 |
| Find all providers in DACULA | ||||
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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.