MOONLIGHTING INC (NPI# 1366758591) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366758591 |
| Entity Type | Organization |
| Organization Name | MOONLIGHTING INC |
| Practice Address |
14728 Pristine Dr Draper UT 84020-7642 |
| Mailing Address |
Po Box 1344 Draper UT 84020-1344 |
| Practice Telephone | 8015993450 |
| Enumeration Date | 2010-08-25 |
| Last Update Date | 2010-08-25 |
| Authorized Official Name | MR. LAYNE KILPATRICK (PRESIDENT, CEO) |
| Authorized Official Telephone | 8015993450 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QC1500X |
Clinic/Center Specialization: Community Health |
Ambulatory Health Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | Moonlighting Inc. | 5300 Hickory Park Dr, Glen Allen, Virginia 23059-2629 |
| Street Address |
14728 PRISTINE DR |
| City | DRAPER |
| State | UT |
| Zip Code | 84020-7642 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194322776 | Chase Larsen Dmd Pllc | Dentist | 723 E 12200 S, Draper, UT 84020 | 2020-10-06 |
| 1780222380 | Derek Cragun | Counselor | 11706 700 E, Draper, UT 84020 | 2019-12-13 |
| 1720629371 | Own My Health Medical | Clinic/Center | 12371 900 E, Suite 102, Draper, UT 84020 | 2019-10-04 |
| 1508418856 | Thomas Mifflin | Physician Assistant | 721 East 12200 South, Draper, UT 84020 | 2019-07-16 |
| 1124670872 | Necia Dalley | Registered Nurse | 11800 S State St, Draper, UT 84020 | 2019-07-12 |
| 1285100784 | Tracey M Williams | Psychologist | 13200 S 1601 E, Draper, UT 84020 | 2018-10-23 |
| 1275008328 | Amoni Paeahelotu Finau | Community Health Worker | 13703 Wheatfield Way, Draper, UT 84020 | 2018-10-04 |
| 1891275525 | Cynthia Mae Bolton | Psychologist | 1192 E Draper Parkway # 447, Draper, UT 84020 | 2018-08-21 |
| 1164908026 | Headin' Home Inc. | Community/Behavioral Health | 12300 S. 150 W., Draper, UT 84020 | 2018-07-13 |
| 1366932576 | Forest Hulet | Dentist | 219 E 12300, Ste I-5, Draper, UT 84020 | 2018-05-14 |
| Find all providers in zip 84020 | ||||
| Taxonomy Code | 261QC1500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Community Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104122720 | Wasathc Health Solutions | Clinic/Center | 1135 Parkstone Dr, Draper, UT 84020-8305 | 2011-01-28 |
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| 1871040774 | Core Helath and Wellness | Clinic/Center | 1898 W 3500 S, Salt Lake City, UT 84119-3436 | 2016-09-08 |
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| 1609254796 | Midtown Community Health Center Inc | Clinic/Center | 269 W 3300 S, Ogden, UT 84401-8440 | 2015-05-11 |
| 1407288400 | Elk Ridge Assisted Living | Clinic/Center | 218 W Olympic Dr, Elk Ridge, UT 84651-5712 | 2013-08-01 |
| 1467644740 | Midtown Community Health Center Inc | Clinic/Center | 22 S State Street, Clearfield, UT 84015 | 2007-08-10 |
| 1093863342 | Wayne Community Health Centers Inc | Clinic/Center | 30 South Hwy 95, Hanksville, UT 84734 | 2007-01-05 |
| 1861587081 | Bear Lake Community Health Center Pharmacy | Clinic/Center | 325 West Logan Hwy., Garden City, UT 84028 | 2006-10-04 |
| 1093816282 | Wayne Community Health Centers Inc | Clinic/Center | 128 S 300 W, Bicknell, UT 84715 | 2006-09-26 |
| 1417347113 | Sunshine Terrance | Clinic/Center | 209 W 300 N, Logan, UT 84321-3809 | 2015-02-02 |
| 1568886000 | Wayne Community Health Centers Inc | Clinic/Center | 570 E Moqui Ln, Escalante, UT 84726-0276 | 2014-02-04 |
| Find all providers with the same taxonomy | ||||
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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.