Active NPI
John E Moran, M.D.
- Family Medicine Physician
- Evansville, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 01029646A
- Practice address
- 4506 1St Ave
Evansville, IN 47710-3324 - Phone
- (812) 428-6161
- Fax
- (812) 421-2883
- NPI assigned
- Mar 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 01029646A | IN | Primary |
Addresses
Primary practice location
4506 1St Ave
Evansville, IN 47710-3324
Mailing address
PO Box 1510
Evansville, IN 47706-1510
Phone (812) 428-6161
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100151700 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01029646A | IN | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Deaconess Clinic Inc. | Current | Accepting new patients | |
| Deaconess Clinic Inc. | Family Medicine | Current | Accepting new patients |
| Deaconess Clinic Inc | Family Medicine | Current | Accepting new patients |
Locations
4506 N 1st Ave
Evansville, IN 47710
Phone (812) 428-6161
421 Chestnut St
Evansville, IN 47713
Phone (812) 426-6645
3844 N 1st Ave
Evansville, IN 47710
Phone (812) 421-2884
1204 Williams St
Oakland City, IN 47660
Phone (812) 749-6187
1414 W Broadway St
Princeton, IN 47670
Phone (812) 385-5283
Organizations & group practices 3
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.
-
- Internal Medicine Physician
- Evansville, IN
- NPI 1619123585
-
- Family Medicine Physician
- Evansville, IN
- NPI 1871749184
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1374624000000",
"number": "1265401434",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1510",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477061510",
"telephone_number": "812-428-6161",
"fax_number": "812-421-2883"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4506 1ST AVE",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477103324",
"telephone_number": "812-428-6161",
"fax_number": "812-421-2883"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORAN",
"first_name": "JOHN",
"middle_name": "E",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-17",
"last_updated": "2013-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IN",
"license": "01029646A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100151700",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Evansville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2013; 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.