Individual provider Active NPI

Karen Kay Moore, FNP

  • Family Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1407327588
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2018034587 Issued in MO
Practice address
5201 Mid America PLZ
Div Im Cardiology, Ste 2300
Saint Louis, MO 63129-0002
Phone
(314) 362-1291
Fax
(314) 286-1949
NPI assigned
Dec 16, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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 2018034587 MO Primary

Addresses

Primary practice location

5201 Mid America PLZ
Div Im Cardiology, Ste 2300
Saint Louis, MO 63129-0002

Mailing address

PO Box 7412011
Chicago, IL 60674-2011
Phone (314) 362-1291

Other identifiers 1

IdentifierTypeStateIssuer
420064800MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20181228000290 MO Practitioner - Nurse Practitioner 5799020475 Reassigns benefits to 5 organizations
I20211123001573 IL Practitioner - Nurse Practitioner 5799020475 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2018034587MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ahs Il Medical Group LLC CurrentSince Nov 14, 2023 Accepting new patients
Mercy Hospital Jefferson CurrentSince Apr 3, 2023 Accepting new patients
Mercy Clinic East Communities CurrentSince Jan 13, 2019 Accepting new patients
Mercy East Ambulatory Services LLC CurrentSince Jun 1, 2022 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince May 22, 2020 Accepting new patients
Mercy Hospital Jefferson CurrentSince Apr 3, 2023 Accepting new patients
Washington University Past Accepting new patients
Emergency Physicians of St. Luke'S, LLC Past Accepting new patients

Locations

1 Saint Anthonys Way
Alton, IL 62002
Phone (618) 233-6870

1000 Eleven S
Ste 1A
Columbia, IL 62236
Phone (618) 281-8400

4273 S State Route 159
Glen Carbon, IL 62034
Phone (618) 288-2297

2100 Madison Ave
Granite City, IL 62040
Phone (618) 798-3000

8 Doctors Park Rd
Mount Vernon, IL 62864
Phone (618) 244-5500

15740 South Outer 40 Rd
Chesterfield, MO 63017
Phone (636) 735-4268

1400 US Highway 61
Crystal Cty, MO 63028
Phone (636) 933-1111

409 Lafayette Ctr
Manchester, MO 63011
Phone (636) 707-0764

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

1605 Martin Springs Dr
Ste 110
Rolla, MO 65401
Phone (573) 458-6300

10010 Kennerly Rd
Saint Louis, MO 63128
Phone (314) 525-1328

621 S New Ballas Rd
Ste 4017B
Saint Louis, MO 63141
Phone (314) 872-9192

4460 S Lindbergh Blvd
Saint Louis, MO 63127
Phone (314) 843-7557

621 S New Ballas Rd
Ste 189A
Saint Louis, MO 63141
Phone (314) 251-6335

555 Washington Sq
Washington, MO 63090
Phone (636) 390-1777

901 Patients First Dr
Ste 1200
Washington, MO 63090
Phone (636) 390-1777

Organizations & group practices 10

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": "1544918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1407327588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412011",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742011",
            "telephone_number": "314-362-1291",
            "fax_number": "314-286-1949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 MID AMERICA PLZ",
            "address_2": "DIV IM CARDIOLOGY, STE 2300",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631290002",
            "telephone_number": "314-362-1291",
            "fax_number": "314-286-1949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "KAREN",
        "middle_name": "KAY",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-16",
        "last_updated": "2025-04-17",
        "certification_date": "2023-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2018034587",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "420064800",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "5201 Mid America Plz",
            "address_2": "Div IM Cardiology, Ste 2300",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631290002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.