Individual provider Active NPI

Ann Roberts Moore, NP

  • Family Nurse Practitioner
  • Tucson, AZ
National Provider Identifier
1104167386
Registry record updated Jul 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP10573 Issued in AZ
Practice address
6200 N la Cholla Blvd
Tucson, AZ 85741-3529
Phone
(520) 742-9000
NPI assigned
Mar 12, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP10573 AZ Primary
Nurse Practitioner 363L00000X AP10573 AZ
Family Nurse Practitioner 363LF0000X 71003777A IN
Family Nurse Practitioner 363LF0000X 18365-33 WI

Addresses

Primary practice location

6200 N la Cholla Blvd
Tucson, AZ 85741-3529

Mailing address

3245 Health Drive
Suite 100
Granger, IN 46530-3245
Phone (574) 647-1840

Other practice location 1

7916 W Jefferson Blvd
Fort Wayne, IN 46804-4140
Phone (260) 432-2297

Other practice location 2

500 Arcade Ave
Ste 210
Elkhart, IN 46514-2485
Phone (574) 389-5656

Other identifiers 1

IdentifierTypeStateIssuer
300012625MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address anne.moore@lutheranhealthnetwork.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, AZ, NC, IA, WV, MI, VA, WI8 enrollments
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 8

Enrollment IDStateProvider typePAC IDDetails
I20180309001349 IN Practitioner - Nurse Practitioner 5092076935 Reassigns benefits to 2 organizations
I20250408002075 AZ Practitioner - Nurse Practitioner 5092076935 Reassigns benefits to 1 organization
I20250505001666 NC Practitioner - Nurse Practitioner 5092076935 Reassigns benefits to 1 organization
I20250718003796 IA Practitioner - Nurse Practitioner 5092076935 Reassigns benefits to 1 organization
I20250822003418 WV Practitioner - Nurse Practitioner 5092076935 Reassigns benefits to 1 organization
I20250829001392 MI Practitioner - Nurse Practitioner 5092076935 Reassigns benefits to 1 organization
I20251204000510 VA Practitioner - Nurse Practitioner 5092076935 Reassigns benefits to 1 organization
I20260601000105 WI Practitioner - Nurse Practitioner 5092076935 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Apogee Medical Group Iowa PCGroup PAC ID 2860572484, 21 clinicians
Apogee Medical Group North CarolinaGroup PAC ID 7719162254, 78 clinicians
Apogee Medical Group IncGroup PAC ID 2961314265, 85 clinicians
Apogee Medical Group Michigan PCGroup PAC ID 9931347879, 42 clinicians

Practice addresses (Care Compare)

1001 Pennsylvania Ave
Ottumwa, IA 52501-2186
Phone (641) 684-2300

317 Western Blvd
Jacksonville, NC 28546-6338
Phone (910) 577-2345

5330 S Hwy 95
Fort Mohave, AZ 86426-9225
Phone (928) 788-7077

850 W Baraga Ave
Marquette, MI 49855-4550
Phone (906) 449-3747

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Apogee Medical Group North Carolina CurrentSince May 1, 2025 Accepting new patients
Apogee Medical Group, West Virginia, PLLC Nurse Practitioner CurrentSince Jul 1, 2025 Accepting new patients
Beacon Medical Group Inc CurrentSince Feb 13, 2022 Accepting new patients
Apogee Medical Group Virginia, PC CurrentSince Nov 1, 2025 Accepting new patients
Apogee Medical Group Inc CurrentSince Feb 5, 2025 Accepting new patients
Beacon Medical Group, Inc. Current Accepting new patients
Apogee Medical Group Inc CurrentSince Feb 5, 2025 Accepting new patients
Apogee Medical Group, Michigan, PC CurrentSince Aug 1, 2025 Accepting new patients
Apogee Medical Group Iowa PC CurrentSince Jun 14, 2025 Accepting new patients
Beacon Medical Group, Inc. CurrentSince Feb 13, 2022 Accepting new patients
Apogee Medical Group Indiana PC CurrentSince Feb 15, 2025 Accepting new patients
Apogee Behavioral Medicine Virginia PC PastSince Mar 24, 2025 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

5330 S Highway 95
Fort Mohave, AZ 86426
Phone (928) 788-2273

101 Civic Center Ln
Lk Havasu Cty, AZ 86403
Phone (928) 453-0150

807 S Ponderosa St
Payson, AZ 85541
Phone (520) 474-3222

1001 Pennsylvania Ave
Ottumwa, IA 52501
Phone (641) 472-4111

500 Arcade Ave
Ste 210
Elkhart, IN 46514
Phone (574) 389-5656

600 East Blvd
Elkhart, IN 46514
Phone (574) 294-2621

6913 N Main St
Granger, IN 46530
Phone (574) 647-1500

3245 Health Dr
Ste 100
Granger, IN 46530
Phone (574) 647-2129

520 S 7th St
Vincennes, IN 47591
Phone (812) 885-3280

850 W Baraga Ave
Marquette, MI 49855
Phone (906) 225-3595

317 Western Blvd
Jacksonville, NC 28546
Phone (910) 577-2240

615 Ridge Rd
Roxboro, NC 27573
Phone (336) 503-5699

142 S Main St
Danville, VA 24541
Phone (434) 799-2100

320 Hospital Dr
Martinsville, VA 24112
Phone (276) 666-7200

1710 Harper Rd
Beckley, WV 25801
Phone (304) 252-0641

20 Hospital Dr
Logan, WV 25601
Phone (304) 792-1101

Interoperability endpoints

  • Direct secure messaging: anne.moore@lutheranhealthnetwork.cernerdirect.com
  • Direct secure messaging: poa4374@yourcarecommunity.org

Organizations & group practices 14

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 14

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1363046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784246400000",
    "number": "1104167386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 HEALTH DRIVE",
            "address_2": "SUITE 100",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465303245",
            "telephone_number": "574-647-1840",
            "fax_number": "260-479-3520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 N LA CHOLLA BLVD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857413529",
            "telephone_number": "520-742-9000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7916 W Jefferson Blvd",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468044140",
            "country_code": "US",
            "telephone_number": "260-432-2297",
            "fax_number": "260-434-6433",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 Arcade Ave",
            "address_2": "Ste 210",
            "address_purpose": "LOCATION",
            "city": "Elkhart",
            "state": "IN",
            "postal_code": "465142485",
            "country_code": "US",
            "telephone_number": "574-389-5656",
            "fax_number": "574-523-7891",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ANN",
        "middle_name": "ROBERTS",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-12",
        "last_updated": "2026-07-17",
        "certification_date": "2026-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP10573",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "AP10573",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71003777A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "18365-33",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300012625",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "anne.moore@lutheranhealthnetwork.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "7916 W Jefferson Blvd",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468044140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.