Individual provider Active NPI

Kelsey Jo Moore, NP

  • Adult Health Nurse Practitioner
  • Muncie, IN
National Provider Identifier
1104220086
Registry record updated Mar 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
71005216A Issued in IN
Practice address
3631 N Morrison Rd
Muncie, IN 47304-5547
Phone
(765) 213-6304
Fax
(765) 213-6304
NPI assigned
Oct 21, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 71005216A IN Primary
Nurse Practitioner 363L00000X 28189740A IN

Addresses

Primary practice location

3631 N Morrison Rd
Muncie, IN 47304-5547

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Other practice location 1

349 W 1st St
Albany, IN 47320-1705
Phone (765) 780-9850

Other names 1

  • Kelsey Riggs Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kelsey.moorenp.p39@direct.ahni.nextgenshare.com Direct
Direct Messaging Address kmoore24@direct.iuhealth.org Direct

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150112001983 IN Practitioner - Nurse Practitioner 6507180981 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry County Memorial HospitalGroup PAC ID 6002724085, 153 clinicians

Practice addresses (Care Compare)

602 N 5TH St
Middletown Family HLTH Partners
Middletown, IN 47356-1008
Phone (765) 518-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28189740AINMDNurse Practitioner
71005216AINMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Henry County Memorial Hospital CurrentSince Sep 1, 2024 Accepting new patients
Henry County Memorial Hospital Current Accepting new patients
Henry County Memorial Hospital Nurse Practitioner CurrentSince Sep 1, 2024 Accepting new patients
Indiana University Health Ball Memorial Physicians, Inc. Nurse Practitioner CurrentSince Nov 29, 2021 Accepting new patients
Major Hospital Past Accepting new patients
Heritage House of Richmond Past Accepting new patients

Locations

3832 Solutions Ctr
Chicago, IL 60677

349 W 1st St
Albany, IN 47320
Phone (765) 789-4541

415 E Main St
Cambridge City, IN 47327
Phone (765) 478-4541

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

602 N 5th St
Middletown, IN 47356
Phone (765) 354-2062

221 N Celia Ave
Muncie, IN 47303
Phone (765) 747-3141

152 Wittenbraker Ave
New Castle, IN 47362
Phone (765) 521-1483

2200 Forest Ridge Pkwy
New Castle, IN 47362
Phone (765) 521-7385

2200 Forest Ridge Pkwy
Ste 310
New Castle, IN 47362
Phone (765) 599-3400

Interoperability endpoints

  • Direct secure messaging: kelsey.moorenp.p39@direct.ahni.nextgenshare.com

Organizations & group practices 6

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.

Hospital & facility affiliations 2

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": "1413849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647561600000",
    "number": "1104220086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3631 N MORRISON RD",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473045547",
            "telephone_number": "765-213-6304",
            "fax_number": "765-213-6304"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "349 W 1st St",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "IN",
            "postal_code": "473201705",
            "country_code": "US",
            "telephone_number": "765-780-9850",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "KELSEY",
        "middle_name": "JO",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-21",
        "last_updated": "2022-03-18",
        "certification_date": "2022-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IN",
            "license": "71005216A",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "28189740A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kelsey.moorenp.p39@direct.ahni.nextgenshare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "3631 N Morrison Rd",
            "city": "Muncie",
            "state": "IN",
            "country_code": "US",
            "postal_code": "473045547",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmoore24@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3631 N Morrison Rd",
            "city": "Muncie",
            "state": "IN",
            "country_code": "US",
            "postal_code": "473045547",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KELSEY",
            "last_name": "RIGGS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Muncie, IN

Sources for this page

Verify at the official NPI Registry.