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Deactivated NPI 1104307297 Deactivated / Inactive NPI Male Practitioner

Todd Moon

Technician, Other • Blanding, UT

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Todd Moon has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date August 27, 2018
NPI Deactivation Date December 28, 2022
Total Practice Duration ~4 Years of Practice (2018 – 2022)

Professional Overview & Biography Verified Profile Summary

Todd Moon was a registered Technician, Other practicing in Blanding, UT. Throughout an active medical career spanning 4 years, Todd Moon provided care at the practice location at 735 S 200 W STE 1 until profile deactivation on 2022-12-28.

Practice Location & Contact Primary Location

Practice Address

735 S 200 W Ste 1

Blanding, UT 845113909

Telephone 4356782992
Fax 4356783116
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Technician, Other in Blanding, UT

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
32 Specialists

Practicing in Blanding, UT (482 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Technician, Other Primary Specialty

NUCC Taxonomy Code: 247200000X

A collective term for persons with specialized training in various narrow fields of expertise whose occupations require training and skills in specific technical processes and procedures; and where further classification is deemed unnecessary by the user.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Wandalyn Bornemann

Case Manager/Care Coordinator

NPI 1023901337
Rita Nakai

Technician, Other

NPI 1053624023
Jeffrey Fitzgerald

Technician, Other

NPI 1053777540
Jenna Larose

Registered Nurse

NPI 1063753655
Dominique Sherrow

Technician, Other

NPI 1063920221
Lita Nakai

Technician, Other

NPI 1073826046

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated December 28, 2022

Record deactivated on December 28, 2022

NPI Profile Active August 27, 2018

NPI status registered as active in NPPES database

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Updated Practice Location August 27, 2018

Registered at 735 S 200 W STE 1, BLANDING, UT 845113909 (Tel: 4356782992)

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Updated Business Mailing Address August 27, 2018

Registered at 735 S 200 W STE 1, BLANDING, UT 845113909 (Tel: 4356782992)

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Provider Name / Credentials Updated August 27, 2018

Recorded as TODD MOON

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Medical Taxonomy / Specialty Registered (Primary Specialty) August 27, 2018

Technician, Other

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Initial NPI Registration & Enumeration August 27, 2018

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1104307297
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 27, 2018
Last Update: August 27, 2018
Deactivation Date: December 28, 2022

Mailing Address

735 S 200 W Ste 1

Blanding, UT 845113909

Phone: 4356782992

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.