Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Laura Diane Moon

Individual provider Registered Nurse · NPI 1003066259

Laura Diane Moon is a Certified Registered Nurse Anesthetist (CRNA) in Greenwood, South Carolina. Qualified in 1997, 29 years ago. Practices with Self Medical Group, a 396-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in South Carolina and West Virginia.

Years since qualifying
29
Licensed in
SC, WV
In the registry since
2008
Specialties on file
3
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Practice location Address checks out

1325 Spring St
Greenwood, SC 29646-3860
Phone: (864) 725-4111
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 4605 Maccorkle Ave Sw, South Charleston, WV 25309-1311 — (304) 766-3600

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 26055 (SC)
Registered Nurse Taxonomy 163W00000X · Licence 55025 (WV)
Certified Registered Nurse Anesthetist Taxonomy 367500000X · Licence 79610 (WV)

Record details

NPI number1003066259
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedSeptember 24, 2008
Last updated in NPPESMarch 15, 2024
Certification dateMarch 15, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 1997 (29 years in practice)
Group practice Self Medical Group — 396 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Greenwood