| Moonlight Diagnostics Llc | |
| 3188 Parliament Cir Ste 802 Montgomery AL 36116-7271 | |
| (334) 416-8298 | |
| (833) 260-4473 | 
| Full Name | Moonlight Diagnostics Llc | 
|---|---|
| Speciality | Psychiatry & Neurology | 
| Location | 3188 Parliament Cir Ste 802, Montgomery, Alabama | 
| Authorized Official Name and Position | Gregory R Lipscomb (PRESIDENT) | 
| Authorized Official Contact | 2515547798 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Moonlight Diagnostics Llc 3188 Parliament Cir Ste 802 Montgomery AL 36116-7271 Ph: (334) 416-8298 | Moonlight Diagnostics Llc 3188 Parliament Cir Ste 802 Montgomery AL 36116-7271 Ph: (334) 416-8298 | 
| NPI Number | 1801351291 | 
|---|---|
| Provider Enumeration Date | 02/10/2019 | 
| Last Update Date | 06/03/2019 | 
| Medicare PECOS PAC ID | 9335480730 | 
|---|---|
| Medicare Enrollment ID | O20190412000655 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1801351291 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary | 
| Provider Name | Gregory R Lipscomb | 
|---|---|
| Provider Type | Practitioner - Neurology | 
| Provider Identifiers | NPI Number: 1427218114 PECOS PAC ID: 4587846423 Enrollment ID: I20110314000517 | 
| Provider Name | Amanda D Hargrove | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1568895589 PECOS PAC ID: 6608094537 Enrollment ID: I20140905001406 | 
| Provider Name | Caroline Brawley Johnson | 
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional | 
| Provider Identifiers | NPI Number: 1811688419 PECOS PAC ID: 4880050343 Enrollment ID: I20230525002533 | 
| Inmed Clinical Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5303 Vaughn Rd, Montgomery, AL 36116 Phone: 334-383-0343 Fax: 334-386-0382 | |
| Med-art In Motion, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1720 W 3rd St, Montgomery, AL 36106 Phone: 334-649-2966 | |
| Spectrum Specialists Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3967 Ray Dr, Montgomery, AL 36109 Phone: 225-362-7048 | |
| Eric B. Hedberg, M.d., Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1040 Longfield Ct, Montgomery, AL 36117 Phone: 334-288-9009 Fax: 334-288-9497 | |
| Metime Mogul Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1375 Federal Dr, Montgomery, AL 36107 Phone: 334-440-6437 | |
| Therapeutic Counseling Services, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3661 Oak Shadow Ln, Montgomery, AL 36116 Phone: 334-318-1182 | |
| Harmony Solutions Counseling Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2059 Vaughn Ln, Montgomery, AL 36106 Phone: 503-395-4648 |