Individual provider Active NPI

Megan Claudine Moriarty, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Lafayette, IN
National Provider Identifier
1285306332
Registry record updated Sep 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
71012790A Issued in IN
Practice address
1904 Shenandoah CT
Lafayette, IN 47905-4043
Phone
(765) 421-4632
NPI assigned
Sep 28, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 28175923A IN
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X 71012790A IN Primary

Addresses

Primary practice location

1904 Shenandoah CT
Lafayette, IN 47905-4043

Mailing address

1904 Shenandoah CT
Lafayette, IN 47905-4043
Phone (765) 421-4632

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
I20220812003017 IN Practitioner - Nurse Practitioner 2466835194 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Valley Oaks Health IncGroup PAC ID 7315927563, 45 clinicians

Practice addresses (Care Compare)

415 N 26TH St
Lafayette, IN 47904-2895
Phone (765) 446-6549

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
71012790AINMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Oaks Health Inc Single Specialty CurrentSince Jul 18, 2022 Accepting new patients
Valley Oaks Health Inc CurrentSince Jul 18, 2022 Accepting new patients

Locations

415 N 26th St
Lafayette, IN 47904
Phone (765) 446-6400

415 N 26th St
Ste 201
Lafayette, IN 47904
Phone (765) 446-6535

610 Main St
Lafayette, IN 47901
Phone (765) 423-2638

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": "1632787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663286400000",
    "number": "1285306332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1904 SHENANDOAH CT",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479054043",
            "telephone_number": "765-421-4632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1904 SHENANDOAH CT",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479054043",
            "telephone_number": "765-421-4632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORIARTY",
        "first_name": "MEGAN",
        "middle_name": "CLAUDINE",
        "name_prefix": "Ms.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-28",
        "last_updated": "2022-09-16",
        "certification_date": "2022-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28175923A",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IN",
            "license": "71012790A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, IN

Sources for this page

Verify at the official NPI Registry.