Individual provider Active NPI

Lori Moton, AGPCNP-BC

  • Gerontology Nurse Practitioner
  • Urbana, IL
National Provider Identifier
1154878098
Registry record updated Aug 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
277003668 Issued in IL
Practice address
1109 S Lincoln Ave
Urbana, IL 61801-4703
Phone
(217) 333-2700
Fax
(217) 244-6495
NPI assigned
Sep 8, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X 041341511 IL
Gerontology Nurse Practitioner 363LG0600X 277003668 IL Primary

Addresses

Primary practice location

1109 S Lincoln Ave
Urbana, IL 61801-4703

Mailing address

1109 S Lincoln Ave
Urbana, IL 61801-4703
Phone (217) 333-2700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20170216001024 IL Practitioner - Nurse Practitioner 1658654660 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
041341511ILMDHome Health Registered Nurse
277003668ILMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates, PLLC CurrentSince Sep 19, 2023 Accepting new patients
Vitae Health Medical Illinois, PLLC CurrentSince Dec 10, 2021 Accepting new patients

Locations

303 E Wacker Dr
Ste 1127
Chicago, IL 60601
Phone (312) 328-2347

801 N Logan Ave
Danville, IL 61832
Phone (217) 443-3106

4055 Valley View Ln
Ste 700
Dallas, TX 75244
Phone (469) 466-7424

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1473292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755648000000",
    "number": "1154878098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1109 S LINCOLN AVE",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618014703",
            "telephone_number": "217-333-2700",
            "fax_number": "217-244-6495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 S LINCOLN AVE",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618014703",
            "telephone_number": "217-333-2700",
            "fax_number": "217-244-6495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOTON",
        "first_name": "LORI",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-08",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "IL",
            "license": "041341511",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IL",
            "license": "277003668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Urbana, IL

Sources for this page

Verify at the official NPI Registry.