Active NPI
Nicole M Moore, NP
- Adult Health Nurse Practitioner
- New Albany, IN
National Provider Identifier
1700149101
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 28174888A
- Practice address
- 2630 Grant Line Rd
New Albany, IN 47150-4053 - Phone
- (502) 888-1988
- NPI assigned
- Jun 20, 2012
- Last updated
- Feb 16, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 28174888A | IN | Primary |
Addresses
Primary practice location
2630 Grant Line Rd
New Albany, IN 47150-4053
Mailing address
PO Box 381468
Germantown, TN 38183-1468
Other practice location 1
1263 Hospital Dr NW Ste 100
Corydon, IN 47112-2173
Phone (502) 888-1988
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201195330 | Medicaid | IN | |
| 7100307090 | Medicaid | KY |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2630 Grant Line Rd
New Albany, IN 47150-4053
Phone (812) 945-0145
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gastroenterology of Southern Indiana, P.C. | Current | Accepting new patients | |
| Gastroenterology Health Partners, PLLC | Adult Health | Current | Accepting new patients |
Locations
1263 Hospital Dr NW
Ste 100
Corydon, IN 47112
Phone (502) 888-1988
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.
-
- Gastroenterology Physician
- Louisville, KY
- NPI 1982963872
Adult Health, IN
-
- Gastroenterology Physician
- New Albany, IN
- NPI 1356362693
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Baptist Health Floyd
- General Acute Care Hospital
- New Albany, IN
- NPI 1497798847
-
- General Acute Care Hospital
- Corydon, IN
- NPI 1427165455
-
- Critical Access Hospital
- Corydon, IN
- NPI 1851378137
-
dba Norton Clark Hospital
- General Acute Care Hospital
- Jeffersonville, IN
- NPI 1134186315
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1771200000000",
"number": "1700149101",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 381468",
"city": "GERMANTOWN",
"state": "TN",
"postal_code": "381831468"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2630 GRANT LINE RD",
"city": "NEW ALBANY",
"state": "IN",
"postal_code": "471504053",
"telephone_number": "502-888-1988"
}
],
"practiceLocations": [
{
"address_1": "1263 Hospital Dr NW Ste 100",
"address_purpose": "LOCATION",
"city": "Corydon",
"state": "IN",
"postal_code": "471122173",
"country_code": "US",
"telephone_number": "502-888-1988",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MOORE",
"first_name": "NICOLE",
"middle_name": "M",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-06-20",
"last_updated": "2026-02-16",
"certification_date": "2026-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "IN",
"license": "28174888A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "201195330",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7100307090",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in New Albany, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.