GINA RENIA MOONE (NPI# 1457806754) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457806754 |
| Entity Type | Individual |
| Full Name | GINA RENIA MOONE |
| Credential | CRNP |
| Practice Address |
4300 W Main St Ste 300 Dothan AL 36305-1313 |
| Mailing Address |
1414 Elba Hwy Troy AL 36079-6020 |
| Practice Telephone | 3344460076 |
| Practice Fax Number | 3344460203 |
| Mailing Telephone | 3346706726 |
| Mailing Fax Number | 3346706731 |
| Enumeration Date | 2016-08-17 |
| Last Update Date | 2018-03-21 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
1-069998 | AL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4300 W MAIN ST STE 300 |
| City | DOTHAN |
| State | AL |
| Zip Code | 36305-1313 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568430056 | Joseph Harrison Sewell | Family Medicine | 4300 W Main St Ste 300, Dothan, AL 36305-1313 | 2006-03-09 |
| 1194087593 | Southeast Alabama Rural Health Associates | Clinic/Center | 4300 W Main St Ste 300, Dothan, AL 36305-1313 | 2012-06-12 |
| 1225346265 | Janet Lynn Ellis | Social Worker | 4300 W Main St Ste 300, Dothan, AL 36305-1313 | 2010-09-23 |
| 1043251036 | James R Staheli | Family Medicine | 4300 W Main St Ste 300, Dothan, AL 36305-1313 | 2006-06-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962059998 | Samantha Nicole Bolden | Counselor | 1001 John D. Odom Road, Dothan, AL 36305 | 2019-08-23 |
| 1578968780 | Aba Therapy & Consulting Services | Behavioral Analyst | 3124 West Main Street, Suite 9, Dothan, AL 36305 | 2014-10-30 |
| 1306247796 | Tracey Lynn Carter | Registered Nurse | 4300 W Main St Ste 102, Dothan, AL 36305 | 2014-09-04 |
| 1760829881 | Michael Brent Nance | Nurse Practitioner | 4370 West Main Street, Dothan, AL 36305 | 2013-05-30 |
| 1033495221 | Professional Resource Management of Wiregrass, LLC | Psychiatry & Neurology | 2812 Hartford Hwy Ste 1, Dothan, AL 36305 | 2011-11-01 |
| 1649555483 | Ashley Dawn Morrow | Pharmacist | 2940 West Main Street, Dothan, AL 36305 | 2011-10-12 |
| 1740599273 | Aline M Mays-easley | Counselor | 309 Ameris Ave, Dothan, AL 36305 | 2010-10-01 |
| 1356671408 | Kimberly Jones Rogers | Clinical Neuropsychologist | 200 Grove Park Ln Ste 212, Dothan, AL 36305 | 2010-01-12 |
| 1639347818 | Southeast Alabama Counseling & Behavioral Specialist | Residential Treatment Facility, Emotionally Disturbed Children | 407 Honeysuckle Rd Ste 207, Dothan, AL 36305 | 2008-02-11 |
| 1770705667 | Michala Long | Pharmacist | 3850 West Main St, Dothan, AL 36305 | 2007-05-02 |
| Find all providers in zip 36305 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295362408 | Stephen M Pendergraft | Nurse Practitioner | 4740 W Main St, Dothan, AL 36305-9423 | 2020-03-26 |
| 1689205767 | Sassy Lashawn Sylvester | Nurse Practitioner | 410 Ridgeland Rd, Dothan, AL 36301-1117 | 2020-01-28 |
| 1700344488 | Gregory Keith Tice | Nurse Practitioner | 1118 Ross Clark Cir Ste 704, Dothan, AL 36301-3030 | 2019-03-12 |
| 1144732520 | Kasey Duffie Chance | Nurse Practitioner | 211 Brushfire Dr, Dothan, AL 36305-7069 | 2017-10-25 |
| 1306364062 | Janeetra Janiece Coachman | Nurse Practitioner | 9 Trillium Cir Apt 1401, Dothan, AL 36301-7653 | 2017-09-01 |
| 1265954010 | Melanie Jo Ellison | Nurse Practitioner | 973 Dunn Rd, Dothan, AL 36303-1056 | 2017-07-13 |
| 1679012629 | Elva Calderon | Nurse Practitioner | 1736 E Main St Ste 100, Dothan, AL 36301-3040 | 2017-02-22 |
| 1649610395 | Kelli Saage Anderson | Nurse Practitioner | 1146 Ross Clark Cir, Dothan, AL 36301-3022 | 2013-06-26 |
| 1902040090 | Cindy Ruth Hemendinger | Nurse Practitioner | 3124 Ross Clark Cir, Dothan, AL 36303-3038 | 2009-04-21 |
| 1770737249 | Kelley E Blake | Nurse Practitioner | 4300 W Main St Ste 45, Dothan, AL 36305-1317 | 2008-11-11 |
| Find all providers in DOTHAN | ||||
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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.