Individual provider Active NPI

Kimberly Marie Moran, NURSE PRACTITIONER

  • Gerontology Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1649719154
Registry record updated Sep 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
71007189A Issued in IN
Practice address
8101 Clearvista Pkwy Ste 200
Indianapolis, IN 46256-4675
Phone
(317) 621-5390
Fax
(317) 621-7885
NPI assigned
Feb 16, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 71007189A IN
Primary Care Nurse Practitioner 363LP2300X 71007189A IN
Gerontology Nurse Practitioner 363LG0600X 71007189A IN Primary
Registered Nurse 163W00000X 28128529A IN

Addresses

Primary practice location

8101 Clearvista Pkwy Ste 200
Indianapolis, IN 46256-4675

Mailing address

6626 E 75TH St Ste 500
Indianapolis, IN 46250-2890

Other identifiers 1

IdentifierTypeStateIssuer
300002272MedicaidIN

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
I20170711002631 IN Practitioner - Nurse Practitioner 5890064505 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Physicians of Indiana IncGroup PAC ID 1759416662, 1,569 clinicians

Practice addresses (Care Compare)

9894 E 121St St
Fishers, IN 46037-4154
Phone (317) 621-6060

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28128529AINMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Josephson-Wallack-Munshower Neurology PC CurrentSince Oct 31, 2025 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Aug 28, 2017 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Aug 28, 2017 Accepting new patients
Josephson-Wallack-Munshower Neurology PC Past Accepting new patients
Premier Heart Associates, Inc PastSince Aug 1, 2021 Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

9894 E 121st St
Fishers, IN 46037
Phone (317) 621-2273

6983 Hillsdale Ct
Indianapolis, IN 46250

1400 N Ritter Ave
Ste 220
Indianapolis, IN 46219
Phone (317) 355-1555

8402 Harcourt Rd
Ste 615
Indianapolis, IN 46260
Phone (317) 806-6991

7150 Clearvista Dr
Indianapolis, IN 46256
Phone (317) 355-5041

8101 Clearvista Pkwy
Ste 200
Indianapolis, IN 46256
Phone (317) 621-5390

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.1753
  • Direct secure messaging: kmoran7841@ecommunitydirect.com

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1487203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790121600000",
    "number": "1649719154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST STE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8101 CLEARVISTA PKWY STE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462564675",
            "telephone_number": "317-621-5390",
            "fax_number": "317-621-7885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAN",
        "first_name": "KIMBERLY",
        "middle_name": "MARIE",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-16",
        "last_updated": "2026-09-23",
        "certification_date": "2026-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IN",
            "license": "71007189A",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "IN",
            "license": "71007189A",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IN",
            "license": "71007189A",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28128529A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300002272",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.