KENNETH H. MOON JR DO – NPI #1447226840
Family Medicine

A family medicine physician who specializes in the diagnosis and treatment of addictions.

KENNETH MOON JR is a physician located in DES MOINES, IA. NPPES has assigned the NPI number 1447226840 to KENNETH MOON JR on February 24, 2006. It is a Type-1 NPI, indicating this NPI number is associated with an individual. The primary taxonomy selected by this provider is 207QA0401X from the Health Care Provider Taxonomy code set, which is classified as Family Medicine, specializing in Addiction Medicine

The NPI profile was previously updated about 14 years ago on Aug 09, 2012. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for KENNETH MOON JR below.

NPI Profile for
KENNETH H. MOON JR

NPI Number
1447226840
Enumeration Date

(more than 20 years ago)
Entity Type
Type-1  Individual (Male)
Legal Name
KENNETH H. MOON JR
Credentials
DO
Primary location
2301 EAST 14TH STREET
DES MOINES, IA 50316-1901
Phone: (515) 262-0404 Fax: (515) 262-0489
Mailing address
2301 E 14TH ST
DES MOINES, IA 50316-1901
Phone: (515) 262-0404 Fax: (515) 262-0489
Sole Proprietor
No
Updated
Identifiers

Identifiers for KENNETH MOON JR

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDIA2215236
MEDICAIDIA1447226840
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207QA0401X
- Family Medicine / Addiction Medicine (Primary)
IA 02033

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.