KENNETH H MOON JR DO NPI 1447226840

NPI Information

  • NPI: 1447226840
  • Provider Name: KENNETH H MOON JR, DO
  • Classification: Family Medicine - 207QA0401X
  • Specialization: Addiction Medicine
  • Entity Type: Individual
  • Address: 2301 EAST 14TH STREET
    DES MOINES, IA
    ZIP 50316
  • Phone: (515) 262-0404

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NPI Details

Kenneth H Moon Jr, DO is an addiction medicine family medicine in Des Moines, IA. The provider is a family medicine physician who specializes in the diagnosis and treatment of addictions. Kenneth H Moon Jr, DO NPI is 1447226840. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2301 EAST 14TH STREET
DES MOINES, IA
ZIP 50316-901
Phone: (515) 262-0404
Fax: (515) 262-0489

The enumeration date for this NPI number is 2/24/2006 and was last updated on 8/9/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207QA0401XFamily MedicineAddiction Medicine02033IOWAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1I16495MEDICARE ID-TYPE UNSPECIFIEDIOWA
2719260388MEDICARE PINIOWA
3D46556MEDICARE UPINIOWA
41447226840MEDICAIDIOWA
52215236MEDICAIDIOWA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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