EVAN BLAKE MOON


Address: 145 Kimel Park Dr, Suite 120, Winston Salem, NC 27103-6984
Phone: 3367683212

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 367500000X Nurse Anesthetist, Certified Registered 272878 NC Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 145 KIMEL PARK DR
SUITE 120
City WINSTON SALEM
State NC
Zip Code 27103-6984

Providers in the same location

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
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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 367500000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Anesthetist, Certified Registered

Taxonomy Definition

(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.

Providers in the same taxonomy and city

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
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City WINSTON SALEM
Zip Code 27103

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Dataset Information

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.

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