Elizabeth Victoria Moerman, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

71009428A Issued in IN

Practice address

606 Lincolnway
Valparaiso, IN 46383

Phone

(219) 247-4003

Fax

(574) 203-9702

NPI assigned

Sep 28, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Nurse Practitioner

Interoperability endpoints

• Direct secure messaging: liz.moerman@kwchc.ssdirect.aprima.com

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1569628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693440000000",
    "number": "1003467218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "606 LINCOLNWAY",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463835728",
            "telephone_number": "219-247-4003",
            "fax_number": "574-203-9702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 LINCOLNWAY",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "46383",
            "telephone_number": "219-247-4003",
            "fax_number": "574-203-9702"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2771 E US Highway 6 Ste B",
            "address_purpose": "LOCATION",
            "city": "Kendallville",
            "state": "IN",
            "postal_code": "467559341",
            "country_code": "US",
            "telephone_number": "888-998-7337",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "333 N Alabama St Ste 350",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462042275",
            "country_code": "US",
            "telephone_number": "888-998-7337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOERMAN",
        "first_name": "ELIZABETH",
        "middle_name": "VICTORIA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-28",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71009428A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71009428A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300048648",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300032267",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.info@luxelifemed.com",
            "affiliation": "N",
            "endpointDescription": "Practice Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "606 Lincolnway",
            "city": "Valparaiso",
            "state": "IN",
            "country_code": "US",
            "postal_code": "46383",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Bruce Moberley, D.O.
• Mobile Mental Wellness, LLC
• Mobile Physicians Group LLC
• Mobile Wellness Incorporated
• Kamala B Modur, MD
• Hermann Brice Mofang
• Melissa Moisant
• Alexandria Molaro
• Chava Kristin Molchan
• Katie Moldenhauer, BCBA

• Nurse Practitioner in Valparaiso, IN
• Providers in Valparaiso, IN by specialty
• Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.