Debra A Moon, NNP

Primary specialty

Neonatal Nurse PractitionerTaxonomy code 363LN0000X

License

71006265A Issued in IN

Practice address

8111 Township Line Rd
Indianapolis, IN 46260-2479

Phone

(317) 415-7921

NPI assigned

Jun 28, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Debra A Nourse Former name

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

State licenses

Practice roles

Locations

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.

• St Vincent Pediatric Subspecialties

  • Pediatrics Physician
  • Indianapolis, IN
  • NPI 1013967736
  Medicare reassignment NPD
• St Vincent Pediatric Subspecialties

  • Pediatric Critical Care Medicine Physician
  • Evansville, IN
  • NPI 1851950224
  NPD

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

{
    "created_epoch": "1467072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492560000000",
    "number": "1154772465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10330 N MERIDIAN ST # 300",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462901024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8111 TOWNSHIP LINE RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462602479",
            "telephone_number": "317-415-7921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "DEBRA",
        "middle_name": "A",
        "credential": "NNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-28",
        "last_updated": "2017-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "IN",
            "license": "71006265A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201412030",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBRA",
            "last_name": "NOURSE",
            "middle_name": "A",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kristin Noel Moody, LCSW
• Stephen Patrick Moody, LCSW
• Wanda Rene Moody, MD
• Bradley Moon
• Cindi A Moon
• Heavenly Moon
• Innkyu Moon, PA-C
• Lynette Moon, PA-C
• Susan Michele Moon
• Zachary Moon

• Neonatal Nurse Practitioner in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Neonatal Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2017; 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.