Individual provider Active NPI

Nicole Mosley, M.D.

  • Family Medicine Physician
  • Crown Point, IN
National Provider Identifier
1639583404
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
94-08383 Issued in KS
Practice address
12800 Mississippi Pkwy Ste B201
Crown Point, IN 46307-6902
Phone
(219) 663-7000
Fax
(219) 663-8621
NPI assigned
Jun 19, 2014
Last updated
Aug 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01078091A IN
Family Medicine Physician 207Q00000X 94-08383 KS Primary

Addresses

Primary practice location

12800 Mississippi Pkwy Ste B201
Crown Point, IN 46307-6902

Mailing address

PO Box 781076
Detroit, MI 48278-1076
Phone (317) 528-4800

Other practice location 1

3901 Rainbow Blvd
Ms 4010
Kansas City, KS 66160-8500
Phone (913) 588-1902

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nmosley237177@Direct.FranciscanAlliance.org Direct

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170727002600 IN Practitioner - Family Practice 5698089357 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Kansas School of Med (KC/Wich/Sal), 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Franciscan Physician NetworkGroup PAC ID 3072790682, 1,152 clinicians

Practice addresses (Care Compare)

12800 Mississippi St
B201
Crown Point, IN 46307-6902
Phone (219) 663-7000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01078091AINMDFamily Medicine Physician
94-08383KSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Physician Network Family Medicine CurrentSince Sep 9, 2017 Accepting new patients
Franciscan Physician Network CurrentSince Sep 9, 2017 Accepting new patients

Locations

1704 Lafayette Rd
Ste 4
Crawfordsvlle, IN 47933
Phone (765) 364-3120

12800 Mississippi Pkwy
Ste B201
Crown Point, IN 46307
Phone (219) 663-7000

150 W Washington St
Shelbyville, IN 46176
Phone (317) 392-3211

Interoperability endpoints

  • Direct secure messaging: nmosley237177@direct.franciscanalliance.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1403136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1639583404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781076",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781076",
            "telephone_number": "317-528-4800",
            "fax_number": "317-865-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12800 MISSISSIPPI PKWY STE B201",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463076902",
            "telephone_number": "219-663-7000",
            "fax_number": "219-663-8621"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3901 Rainbow Blvd",
            "address_2": "MS 4010",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "KS",
            "postal_code": "661608500",
            "country_code": "US",
            "telephone_number": "913-588-1902",
            "fax_number": "913-588-8387",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOSLEY",
        "first_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-19",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01078091A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "94-08383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nmosley237177@Direct.FranciscanAlliance.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "12800 Mississippi Pkwy Ste B201",
            "city": "Crown Point",
            "state": "IN",
            "country_code": "US",
            "postal_code": "463076902",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Crown Point, IN

Sources for this page

Verify at the official NPI Registry.