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MR. CHRISTOPHER SCOTT MOON
NPI 1689124117
Counselor - Professional in Grand Rapids, MI

Active since October 07, 2016PECOS Enrolled
790 FULLER AVE NE, GRAND RAPIDS, MI 49503(616) 336-3909(616) 336-8830 Get Directions Write a Review

NPPES record last updated: June 6, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jun 6, 2024, Mar 7, 2024, Aug 24, 2021 (3 updates tracked since 2021).

About Mr. Christopher Scott Moon NPPES

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

MR. CHRISTOPHER SCOTT MOON (NPI 1689124117) is an individual professional provider in Grand Rapids, Michigan, licensed in Michigan (6401223787) and active in the NPI registry since October 2016. He is enrolled in Medicare PECOS and maintains a secondary practice location in Grand Rapids.

NPPES Registry Identity

NPI1689124117
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameMR. CHRISTOPHER SCOTT MOON
Location Address790 FULLER AVE NEGrand Rapids, MI 49503
Mailing Address790 Fuller Ave NeGrand Rapids, MI 49503-1918 · (616) 336-3909 · Fax (616) 336-8830
Phone(616) 336-3909
Fax(616) 336-8830
Sole ProprietorNo
Enumeration DateOctober 7, 2016
Last NPPES UpdateJune 6, 20243 updates tracked since enumeration
NPPES CertifiedJune 6, 2024
✔ NPI 1689124117 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in MI · 6401223787
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X
790 FULLER AVE NE, Grand Rapids, MI 49503
Open in Google Maps ↗

Secondary Practice Location 1

Location 13300 36th St SEGrand Rapids, MI 49512-2810 · Phone (616) 942-2110

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Christopher Scott Moon 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.

Medicare Billing Reassignment

Medicare enrollment records show Christopher Moon reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Kent County Cmh Authority
Same address
Community/Behavioral Health
790 FULLER AVE NE
Grand Rapids, MI 49503
  • Reassigned Medicare billing, Michigan enrollment
  • 164 clinicians in this Medicare group
NPI 1396404588 (616) 336-3909

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

Other Providers at the Same Location NPPES 20

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

DIANA DUARTE-MENENDEZ LMSW
Social Worker (Clinical)
790 FULLER AVE NE
GRAND RAPIDS, MI 49503
Kent County (616) 336-3909
MISS JALISA SHAWTAE SMITH LLMSW
Case Manager/Care Coordinator
790 FULLER AVE NE
GRAND RAPIDS, MI 49503
Kent County (616) 336-3909
MACKENZIE ERIN CLEGG
Behavior Analyst
790 FULLER AVE NE
GRAND RAPIDS, MI 49503
Kent County (616) 336-3909
MRS. ALEITA A BROWN LLBSW
Case Manager/Care Coordinator
790 FULLER AVE NE
GRAND RAPIDS, MI 49503
Kent County (616) 825-5412
ANNIKA KNOTT LMSW
Social Worker (Clinical)
790 FULLER AVE NE
GRAND RAPIDS, MI 49503
Kent County (616) 724-6942
VIOLET RAMAGE
Case Manager/Care Coordinator
790 FULLER AVE NE
GRAND RAPIDS, MI 49503
Kent County (734) 493-2978
DAVID G MARSHALL LPC
Counselor (Professional)
790 FULLER AVE NE
GRAND RAPIDS, MI 49503
Kent County (616) 336-3909
DAWN MARIE MACDONALD LLMSW
Social Worker
790 FULLER AVE NE
GRAND RAPIDS, MI 49503
Kent County (616) 336-3909

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 Christopher Moon's NPI number?

The NPI number for Christopher Moon is 1689124117. It was assigned to this individual provider in the NPPES registry on October 7, 2016.

Where is Christopher Moon located?

Christopher Moon practices at 790 Fuller Ave NE, Grand Rapids, MI 49503. The listed phone number is (616) 336-3909.

What is Christopher Moon's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Christopher Moon enrolled in Medicare?

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

Which organization bills Medicare for Christopher Moon's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Christopher Moon reassigns Medicare benefits to Kent County Cmh Authority (Grand Rapids, MI). The 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 Christopher Moon's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Christopher Moon accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company and 2 other insurers list Christopher Moon as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Christopher Moon was last updated on June 6, 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.