KELLIE JIWON MOON MD
NPI 1376229054
Anesthesiology in Augusta, GA

Active since June 26, 2023PECOS Enrolled
1120 15TH ST # BI-2183, AUGUSTA, GA 30912(706) 721-0180 Get Directions Write a Review

NPPES record last updated: June 26, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Kellie Jiwon Moon Md NPPES

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

KELLIE JIWON MOON MD (NPI 1376229054) is an individual anesthesiology provider in Augusta, Georgia, licensed in Georgia (15209) and active in the NPI registry since June 2023. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1376229054
Entity TypeIndividualFemale
Primary Taxonomy207L00000X
Provider Legal NameKELLIE JIWON MOONCredential: MD
Location Address1120 15TH ST # BI-2183Augusta, GA 30912-0004
Mailing Address1120 15th St # Bi-2183Augusta, GA 30912-0004 · (706) 721-0180
Sole ProprietorNo
Enumeration DateJune 26, 2023
NPPES CertifiedJune 26, 2023
NPI 1376229054 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyAnesthesiologyAllopathic & Osteopathic Physicians
Taxonomy Code207L00000X
License Licensed in GA · 15209
Definition

An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery.

1120 15TH ST # BI-2183, Augusta, GA 30912

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Kellie Jiwon Moon Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Anesthesiology
1120 15TH ST # BI-2183
AUGUSTA, GA 30912
Anesthesiology
1120 15TH ST # BI-2183
AUGUSTA, GA 30912
Anesthesiology
1120 15TH ST # BI-2183
AUGUSTA, GA 30912
Anesthesiology
1120 15TH ST # BI-2183
AUGUSTA, GA 30912
Anesthesiology
1120 15TH ST # BI-2183
AUGUSTA, GA 30912

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 Kellie Moon's NPI number?

The NPI number for Kellie Moon is 1376229054. It was assigned to this individual provider in the NPPES registry on June 26, 2023.

Where is Kellie Moon located?

Kellie Moon practices at 1120 15th St # Bi-2183, Augusta, GA 30912. The listed phone number is (706) 721-0180.

What is Kellie Moon's specialty?

The primary specialty registered for this NPI is Anesthesiology with taxonomy code 207L00000X.

Is Kellie Moon enrolled in Medicare?

Yes. Kellie Moon is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kellie Moon was last updated on June 26, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.