KERI LEIGH MOON (NPI# 1982079315) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982079315 |
| Entity Type | Individual |
| Full Name | KERI LEIGH MOON |
| Other Name | KERI LEIGH STUMP |
| Credential | PA |
| Practice Address |
3201 University Dr E Ste 245 Bryan TX 77802-3483 |
| Mailing Address |
Po Box 202110 Austin TX 78720-2110 |
| Practice Telephone | 9797760700 |
| Practice Fax Number | 9797765624 |
| Mailing Telephone | 5126371797 |
| Mailing Fax Number | 8559591863 |
| Enumeration Date | 2015-12-10 |
| Last Update Date | 2018-07-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA10170 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | PA LICENSE | PA10170 | 01 |
| Street Address |
3201 UNIVERSITY DR E STE 245 |
| City | BRYAN |
| State | TX |
| Zip Code | 77802-3483 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508863564 | Choice Health Services, Inc. | Home Health | 3201 University Dr E, Suite 475, Bryan, TX 77802-3475 | 2005-07-06 |
| 1447877345 | Bcs Eye Associates, Inc. | Ophthalmology | 3201 University Dr E, Bryan, TX 77802-3475 | 2020-06-26 |
| 1316562408 | Vicki Hoang Nhung Nguyen | Optometrist | 3201 University Dr E, Bryan, TX 77802-3475 | 2020-06-15 |
| 1851830111 | Mtr Treatment Corp | Substance Abuse Rehabilitation Facility | 3201 University Dr E, Suite 230, Bryan, TX 77802-3475 | 2017-02-20 |
| 1285082768 | Dcs Medical Pa | Clinic/Center | 3201 University Dr E, Suite 135, Bryan, TX 77802-3475 | 2016-05-25 |
| 1578921391 | Gretchen S. Noble, Psyd, Pllc | Clinic/Center | 3201 University Dr E, Suite 200, Bryan, TX 77802-3475 | 2016-02-08 |
| 1366813958 | Cynthia Shannon, Lmft, Pllc | Marriage & Family Therapist | 3201 University Dr E, Ste 200, Bryan, TX 77802-3475 | 2015-10-08 |
| 1972970531 | Brooke Martin Lpc Pllc | Community/Behavioral Health | 3201 University Dr E, Suite 200, Bryan, TX 77802-3475 | 2015-08-29 |
| 1386010676 | Charles Robert Ridley | Psychologist | 3201 University Dr E, Suite 200, Bryan, TX 77802-3475 | 2015-08-20 |
| 1003206285 | L Justin Gayle Md Pllc | Obstetrics & Gynecology | 3201 University Dr E, Ste 370, Bryan, TX 77802-3475 | 2015-01-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013476951 | Andrea Pittman | Student in an Organized Health Care Education/Training Program | Primary Care Medicine Department, College of Medicine, 2900 East 29th Street, Bryan, TX 77802 | 2019-03-19 |
| 1942789110 | Alicia Diane Ates | Dentist | 3001 Wildflower Drive, Suite #511, Bryan, TX 77802 | 2018-08-09 |
| 1588151682 | Metx LLC | Audiologist-Hearing Aid Fitter | 3030 E 29th St Ste 102, Bryan, TX 77802 | 2018-04-16 |
| 1073047437 | Abbi Messer | Family Medicine | 2900 29th Street, Suite 100, Bryan, TX 77802 | 2017-04-12 |
| 1265885180 | Scott Andrew Thayer | Dentist | 3811 Stoneparc Dr, Bryan, TX 77802 | 2016-07-15 |
| 1255792123 | Phoebe Mathew | Pharmacist | 3312 East 29th Street, Bryan, TX 77802 | 2016-03-18 |
| 1801253810 | Pearl Coleshill | Specialist/Technologist | 3121 University Drive E., Suite 100, Bryan, TX 77802 | 2016-01-21 |
| 1265847750 | Wesley Danielle Daniels | Dietitian, Registered | 3900-c Carter Creek Pkway, Bryan, TX 77802 | 2014-06-24 |
| 1235549098 | Regina V. Robertson | Home Health | 1121 Briarcrest Dr., Suite 102, Bryan, TX 77802 | 2014-05-02 |
| 1982024238 | Lampstand Nursing and Rehabilitation, Lp | Skilled Nursing Facility | 2001 E 29th Street, Bryan, TX 77802 | 2014-04-24 |
| Find all providers in zip 77802 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952627242 | Cody Van Emery | Physician Assistant | 3201 University Dr E Ste 135, Bryan, TX 77802-3481 | 2010-04-13 |
| 1417093998 | Thomas Gayle Powell | Physician Assistant | 1600 Joseph Dr Ste 2202, Bryan, TX 77802-1502 | 2007-01-30 |
| 1700971074 | Amber Anise Mick | Physician Assistant | 3201 University Dr. E, Ste 205, Bryan, TX 77802-3482 | 2006-10-04 |
| 1497317960 | Victoria P Davis | Physician Assistant | 8441 State Highway 47 Ste 4300, Bryan, TX 77807-3235 | 2019-07-03 |
| 1609334556 | Williams Emergency Group, LLC | Physician Assistant | 433 W High St, Bryan, OH 43506-1690 | 2019-03-11 |
| 1023500709 | Ava Smith | Physician Assistant | 8441 State Highway 47 Ste 1400, Bryan, TX 77807-3208 | 2018-05-30 |
| 1275060360 | Lauren Alexandra Mckay | Physician Assistant | 3201 University Dr E Ste 135, Bryan, TX 77802-3481 | 2017-05-19 |
| 1437517539 | Michael Kenneth Freund | Physician Assistant | 2801 Franciscan Dr, Bryan, TX 77802 | 2016-02-03 |
| 1295129153 | Jonathan Ponder | Physician Assistant | 8441 State Highway 47, Suite 4300, Bryan, TX 77807-3207 | 2015-03-27 |
| 1659702504 | William Cooper | Physician Assistant | 1100 Ursuline Ave, Bryan, TX 77803-4951 | 2013-12-03 |
| Find all providers in BRYAN | ||||
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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.