KENNETH H MOON JR (NPI# 1447226840) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447226840 |
| Entity Type | Individual |
| Full Name | KENNETH H MOON JR |
| Credential | DO |
| Practice Address |
2301 East 14th Street Des Moines IA 50316-1901 |
| Mailing Address |
2301 E 14th St Des Moines IA 50316-1901 |
| Practice Telephone | 5152620404 |
| Practice Fax Number | 5152620489 |
| Mailing Telephone | 5152620404 |
| Mailing Fax Number | 5152620489 |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2012-08-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QA0401X |
Family Medicine Specialization: Addiction Medicine |
02033 | IA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | 1447226840 | 05 | |
| IA | 2215236 | 05 |
| Street Address |
2301 EAST 14TH STREET |
| City | DES MOINES |
| State | IA |
| Zip Code | 50316-1901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124626320 | Restoration Behavioral Health Center, Inc. | Clinic/Center | 1235 Sampson Street, Des Moines, IA 50316 | 2020-10-12 |
| 1154928497 | Yeshua Reentry and Recovery Center Inc | Community Health Worker | 1235 Sampson St, Des Moines, IA 50316 | 2020-10-08 |
| 1639594484 | Tripti Kaul | Dentist | 1345 E. University Avenue, #302, Des Moines, IA 50316 | 2014-03-03 |
| 1184979023 | Ashley Marie Mundt | Physical Therapist | 710 Riverview Street, Des Moines, IA 50316 | 2012-07-17 |
| 1942562020 | Angela Maria Runkel | Nurse Practitioner | 1201 Penn Avenue, Penn Avenue Internal Medicine, Des Moines, IA 50316 | 2012-06-13 |
| 1821390121 | Recovercare LLC | Durable Medical Equipment & Medical Supplies | 2117 Dixon St, Des Moines, IA 50316 | 2010-11-19 |
| 1588838841 | Leenu Mishra | Psychiatry & Neurology | 700 East University Ave 3 West, Blank Childrens Psychiatry, Des Moines, IA 50316 | 2008-04-17 |
| 1477721686 | Kristin K Horning | Pharmacist | 840 East University Avenue, Des Moines, IA 50316 | 2008-02-11 |
| 1770695488 | Terrance O Kurtz | Internal Medicine | 2100 Dixon, Suite E Concentra Clinic, Des Moines, IA 50316 | 2006-08-31 |
| 1487281085 | Timothy Andrew Flynn | Behavioral Analyst | 1301 Pennsylvania Ave, Suite #305, Des Moines, IA 50316 | 2020-03-24 |
| Find all providers in zip 50316 | ||||
| Taxonomy Code | 207QA0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Addiction Medicine |
| A family medicine physician who specializes in the diagnosis and treatment of addictions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) was, but is no longer issued by the American Osteopathic Board of Family Physicians. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952542557 | Center for Behavioral Health Iowa, Inc. | Family Medicine | 1200 University Ave Ste 106, Des Moines, IA 50314-2330 | 2009-03-12 |
| 1295830115 | Alan Randal Bollinger | Family Medicine | 3509 E 29th St, Des Moines, IA 50317 | 2006-09-14 |
| 1780650010 | Dennis A Weis | Family Medicine | 700 E University Ave, Des Moines, IA 50316-2302 | 2006-02-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255655635 | David Gerhardt Paulsrud | Family Medicine | 800 5th St, Sioux City, IA 51101-1317 | 2010-03-15 |
| City | DES MOINES |
| Zip Code | 50316 |
Please comment or provide details below to improve the information on KENNETH H MOON JR.
| 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.