EVAN BLAKE MOON (NPI# 1437603891) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437603891 |
| Entity Type | Individual |
| Full Name | EVAN BLAKE MOON |
| Credential | CRNA |
| Practice Address |
145 Kimel Park Dr Suite 120 Winston Salem NC 27103-6984 |
| Practice Telephone | 3367683212 |
| Practice Fax Number | 3367689019 |
| Mailing Telephone | 3367683212 |
| Mailing Fax Number | 3367689019 |
| Enumeration Date | 2016-08-15 |
| Last Update Date | 2016-08-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | 272878 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
145 KIMEL PARK DR SUITE 120 |
| City | WINSTON SALEM |
| State | NC |
| Zip Code | 27103-6984 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447775119 | Emily Moon | Nurse Anesthetist, Certified Registered | 145 Kimel Park Dr, Suite 120, Winston Salem, NC 27103 | 2017-08-03 |
| 1972039329 | Matthew Bryant Foster | Nurse Anesthetist, Certified Registered | 145 Kimel Park Dr, Suite 120, Winston Salem, NC 27103-6984 | 2017-05-04 |
| 1790228278 | Emily Stone | Nurse Anesthetist, Certified Registered | 145 Kimel Park Dr, Suite 120, Winston Salem, NC 27103-6984 | 2016-12-01 |
| 1407309677 | Patrick James Parcell | Nurse Anesthetist, Certified Registered | 145 Kimel Park Dr, Suite 120, Winston Salem, NC 27103-6984 | 2016-07-25 |
| 1518410786 | Jessica Lloyd Rothrock | Nurse Anesthetist, Certified Registered | 145 Kimel Park Dr, Suite 120, Winston Salem, NC 27103-6984 | 2016-07-25 |
| 1063965234 | Benjamin Joseph Boehnlein | Nurse Anesthetist, Certified Registered | 145 Kimel Park Dr, Suite 120, Winston Salem, NC 27103-6984 | 2016-07-25 |
| 1891171682 | Nicholas Dane Pulliam | Nurse Anesthetist, Certified Registered | 145 Kimel Park Dr, Suite 120, Winston Salem, NC 27103-6984 | 2015-08-04 |
| 1790161818 | Deborah Reece | Physician Assistant | 145 Kimel Park Dr, Suite 330, Winston Salem, NC 27103-6984 | 2015-07-31 |
| 1720466840 | Kristen Marisa Bettis | Nurse Anesthetist, Certified Registered | 145 Kimel Park Dr, Suite 120, Winston Salem, NC 27103-6984 | 2015-05-08 |
| 1508244773 | Christine Price Horton | Nurse Anesthetist, Certified Registered | 145 Kimel Park Dr, Suite 120, Winston Salem, NC 27103-6984 | 2015-05-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124648126 | Kelly Anne Wales | Pharmacist | 3917-a Westpoint Boulevard, Winston-salem, NC 27103 | 2020-04-20 |
| 1386281533 | Elena Mcginty | Nurse Practitioner | 1225 Creekshire Way, Suite 270, Winston Salem, NC 27103 | 2019-12-06 |
| 1992359442 | Madeline Pryor | Pharmacist | 255 Charlois Drive, Winston Salem, NC 27103 | 2019-08-01 |
| 1215599584 | Palmetto Oxygen LLC | Durable Medical Equipment & Medical Supplies | 1100 S Stratford Road, Building B, Suite 420, Winston Salem, NC 27103 | 2019-07-07 |
| 1548734718 | Trivy Johnson | Specialist | 1384-b Westgate Center Dr., Winston Salem, NC 27103 | 2019-01-21 |
| 1447745047 | Novant Health Rehabilitation Hospital of Winston-salem, LLC | Rehabilitation Hospital | 2475 Hillcrest Center Circle, Winston Salem, NC 27103 | 2018-06-26 |
| 1346740206 | Joseph Miller | Physical Therapist | 1605 Westbrook Dr, Suite 103, Winston-salem, NC 27103 | 2018-02-17 |
| 1548779101 | Kristin Blow | Counselor | 3000 Bethesda Pl Ste 202, Winston Salem, NC 27103 | 2017-09-27 |
| 1891213443 | Alisha Dawn Wilson | Occupational Therapy Assistant | 2101 Homestead Hills Drive, Winston Salem, NC 27103 | 2017-09-05 |
| 1588186969 | Brandy Wilson | Social Worker | 153 Cameron Way Circle, Winston Salem, NC 27103 | 2017-07-07 |
| Find all providers in zip 27103 | ||||
| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992359905 | Andrea Nicole Magri | Nurse Anesthetist, Certified Registered | 1924 W Academy St, Winston Salem, NC 27103-3779 | 2019-07-29 |
| 1659820025 | Emma Kelsey Ketner Brown | Nurse Anesthetist, Certified Registered | Medical Cetner Blvd, Winston Salem, NC 27157-0001 | 2016-09-27 |
| 1104250968 | Holly Warren Davis | Nurse Anesthetist, Certified Registered | Medial Center Blvd, Winston Salem, NC 27157-0001 | 2013-08-29 |
| 1275882987 | Marie Jackson Dunn | Nurse Anesthetist, Certified Registered | 2120 Queen St, Winston Salem, NC 27103-2505 | 2012-09-10 |
| 1225311525 | Kathryn Weldon Phares | Nurse Anesthetist, Certified Registered | Brenner Childrens Hospital, Medical Center Boulevard, Winston Salem, NC 27157-0001 | 2011-09-22 |
| 1225324890 | Robert Adam Leonard | Nurse Anesthetist, Certified Registered | 1401 Thornhill Ln, Winston Salem, NC 27106-4770 | 2011-06-22 |
| 1285821827 | Cary Tierney Hodshon | Nurse Anesthetist, Certified Registered | 2448 Maplewood Ave, Winston Salem, NC 27103-3535 | 2007-09-27 |
| 1497730543 | William Christian Walton | Nurse Anesthetist, Certified Registered | Wfubmc, Medical Center Boulevard/ambulatory Anesthesia, Winston Salem, NC 27157-0001 | 2005-12-13 |
| 1700860830 | Jeffrey Sorelle Palmer | Nurse Anesthetist, Certified Registered | Medical Center Blvd., Winston Salem, NC 27157-0001 | 2005-12-02 |
| 1841274719 | Pamela Kaye Emerson | Nurse Anesthetist, Certified Registered | Wake Forest University Baptist Medical Ctr, Medical Center Blvd, Winston Salem, NC 27157-0001 | 2005-12-02 |
| Find all providers in WINSTON SALEM | ||||
| City | WINSTON SALEM |
| Zip Code | 27103 |
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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.