Individual provider Active NPI

Jacqueline Linda Moran, CRNA

  • Certified Registered Nurse Anesthetist
  • Louisville, KY
National Provider Identifier
1366727810
Registry record updated Jul 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
3015965 Issued in KY
Practice address
231 E Chestnut St
Louisville, KY 40202-1821
Phone
(502) 629-6000
NPI assigned
Oct 17, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 3015965 KY Primary
Certified Registered Nurse Anesthetist 367500000X ARNP9193933 FL

Addresses

Primary practice location

231 E Chestnut St
Louisville, KY 40202-1821

Mailing address

PO Box 713350
Chicago, IL 60677-1392
Phone (502) 588-9490

Other practice location 1

3501 Johnson St
Hollywood, FL 33021-5421
Phone (954) 838-2588

Other identifiers 1

IdentifierTypeStateIssuer
3015965OtherKYKY STATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230106000653 KY Practitioner - Certified Registered Nurse Anesthetist (Crna) 3779741806 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

231 E Chestnut St
Louisville, KY 40202-1821
Phone (502) 629-1234

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Norton Children's Medical Group, LLC Current Accepting new patients
Norton Children's Medical Group, LLC CurrentSince Jul 25, 2023 Accepting new patients
Norton Children's Medical Group, LLC CurrentSince Jul 25, 2023 Accepting new patients

Locations

601 S Floyd St
Ste 604
Louisville, KY 40202
Phone (502) 559-1670

231 E Chestnut St
Louisville, KY 40202
Phone (502) 852-8500

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.

NPI Registry JSON

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

{
    "created_epoch": "1318809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783555200000",
    "number": "1366727810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713350",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606771392",
            "telephone_number": "502-588-9490",
            "fax_number": "502-272-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 E CHESTNUT ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021821",
            "telephone_number": "502-629-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3501 Johnson St",
            "address_purpose": "LOCATION",
            "city": "Hollywood",
            "state": "FL",
            "postal_code": "330215421",
            "country_code": "US",
            "telephone_number": "954-838-2588",
            "fax_number": "954-514-3979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORAN",
        "first_name": "JACQUELINE",
        "middle_name": "LINDA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-17",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "3015965",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP9193933",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KY STATE LICENSE",
            "identifier": "3015965",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.