Individual provider Active NPI

Sarah Grace Moreno

  • Family Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1396569661
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4030349 Issued in KY
Practice address
3900 Kresge Way Ste 60
Louisville, KY 40207-4690
Phone
(502) 893-7710
NPI assigned
Nov 13, 2024
Last updated
Nov 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4030349 KY Primary

Addresses

Primary practice location

3900 Kresge Way Ste 60
Louisville, KY 40207-4690

Mailing address

320 Highwood Dr
Louisville, KY 40206-3293

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20241217001897 KY Practitioner - Nurse Practitioner 8628505567 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4030349KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Louisville Research Foundation, Inc. CurrentSince May 16, 2025 Accepting new patients
University of Louisville Research Foundation Inc Family Current Accepting new patients
University of Louisville Research Foundation, Inc CurrentSince May 16, 2025 Accepting new patients
Baptist Health Medical Group, Inc. CurrentSince Dec 9, 2024 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Dec 9, 2024 Accepting new patients

Locations

1901 Campus Pl
Louisville, KY 40299
Phone (502) 253-4911

215 Central Ave
Ste 110
Louisville, KY 40208
Phone (502) 852-5205

2400 Eastpoint Pkwy
Ste 570
Louisville, KY 40223
Phone (502) 409-6898

3900 Kresge Way
Ste 41
Louisville, KY 40207
Phone (502) 896-1313

3900 Kresge Way
Ste 60
Louisville, KY 40207
Phone (502) 893-7710

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1731456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1396569661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 HIGHWOOD DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402063293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 KRESGE WAY STE 60",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074690",
            "telephone_number": "502-893-7710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORENO",
        "first_name": "SARAH",
        "middle_name": "GRACE",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-13",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "4030349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.