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MOONTOWER WELLNESS, LLC
NPI 1295092252
Psychiatry & Neurology - Psychiatry in Broomfield, CO

Active since April 16, 2012
11705 AIRPORT WAY STE 205, BROOMFIELD, CO 80021(512) 522-7708 Get Directions Write a Review

NPPES record last updated: May 9, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Moontower Wellness, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MOONTOWER WELLNESS, LLC (NPI 1295092252), doing business as Moontower Mental Wellness, Pllc, is a healthcare organization registered as a psychiatry in Broomfield, Colorado and active in the NPI registry since April 2012. The organization maintains a secondary practice location in Austin and lists William Coleman Weatherby, Member/manager, as its authorized official.

NPPES Registry Identity

NPI1295092252
Entity TypeOrganization
Primary Taxonomy2084P0800X
Legal Business NameMOONTOWER WELLNESS, LLC
Location Address11705 AIRPORT WAY STE 205Broomfield, CO 80021-2710
Mailing Address11705 Airport Way Ste 205Broomfield, CO 80021-2710 · (512) 522-7708 · Fax (512) 233-0824
Phone(512) 522-7708
Organization SubpartNo
Authorized OfficialWilliam Coleman WeatherbyMember/manager · (512) 522-7708
Enumeration DateApril 16, 2012
Last NPPES UpdateMay 9, 2024
NPPES CertifiedMay 9, 2024
✔ NPI 1295092252 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0800X
License✔ Licensed in TX · N6094
Definition
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
11705 AIRPORT WAY STE 205, Broomfield, CO 80021
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Other Names 1

Former Legal Business NameMoontower Mental Wellness, Pllc

Secondary Practice Location 1

Location 11154 Lydia St Ste 110Austin, TX 78702-2619 · Phone (512) 522-7708 · Fax (512) 233-0824

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Moontower Wellness, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Moontower Wellness, LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

William Weatherby, D.O.
Psychiatry
NPI 1306007604
11705 AIRPORT WAY STE 205
Broomfield, CO 80021
(512) 522-7708
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Moontower Wellness, LLC's NPI number?

The NPI number for Moontower Wellness, LLC is 1295092252. It was assigned to this organization in the NPPES registry on April 16, 2012. The provider was formerly known as Moontower Mental Wellness, PLLC.

Where is Moontower Wellness, LLC located?

Moontower Wellness, LLC is located at 11705 Airport Way Ste 205, Broomfield, CO 80021. The listed phone number is (512) 522-7708.

What is Moontower Wellness, LLC's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Is Moontower Wellness, LLC enrolled in Medicare?

Yes. Moontower Wellness, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Moontower Wellness, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Psychiatry) reassigns their Medicare billing to Moontower Wellness, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Moontower Wellness, LLC was last updated on May 9, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.