Individual provider Active NPI

Stephanie Lynn Haler Mora, NP-C

  • Family Nurse Practitioner
  • Jeffersonville, IN
National Provider Identifier
1407188840
Registry record updated Nov 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71003190A Issued in IN
Practice address
1605 Fox Run TRL
Jeffersonville, IN 47130-8205
Phone
(317) 371-4844
NPI assigned
Feb 10, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2016

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 71003190A IN Primary

Addresses

Primary practice location

1605 Fox Run TRL
Jeffersonville, IN 47130-8205

Mailing address

1605 Fox Run TRL
Jeffersonville, IN 47130-8205
Phone (317) 371-4844

Other identifiers 1

IdentifierTypeStateIssuer
200999690MedicaidIN

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
I20101130000789 IN Practitioner - Nurse Practitioner 2264628437 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana University Health Care Associates, Inc Family CurrentSince Oct 31, 2010 Accepting new patients
Icem, LLC Past Accepting new patients

Locations

5208 Reliable Pkwy
Chicago, IL 60686

1115 Ronald Reagan Pkwy
Ste 364
Avon, IN 46123
Phone (317) 217-2636

1111 Ronald Reagan Pkwy
Avon, IN 46123
Phone (317) 217-3000

1701 N Senate Blvd
Bldg C6
Indianapolis, IN 46202
Phone (913) 962-2000

250 N Shadeland Ave
Ste 130
Indianapolis, IN 46219
Phone (317) 962-4836

Interoperability endpoints

  • Direct secure messaging: stephanie.haler.mora.1@21632.direct.athenahealth.com

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": "1265760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478476800000",
    "number": "1407188840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 FOX RUN TRL",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471308205",
            "telephone_number": "317-371-4844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 FOX RUN TRL",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471308205",
            "telephone_number": "317-371-4844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALER MORA",
        "first_name": "STEPHANIE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-10",
        "last_updated": "2016-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71003190A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200999690",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jeffersonville, IN

Sources for this page

Verify at the official NPI Registry.