Mercedes Del Carmen Moran, CNM

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

License

71004286A Issued in IN

Practice address

621 Memorial Dr
Ste 403
South Bend, IN 46601-1063

Phone

(574) 647-1405

NPI assigned

Mar 3, 2006

Last updated

Jan 5, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife

State licenses

Interoperability endpoints

• Direct secure messaging: mercedesmoran@beacon.allscriptsdirect.net

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

{
    "created_epoch": "1141344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515110400000",
    "number": "1710954102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 N NILES AVE",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466171924",
            "telephone_number": "574-647-1610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 MEMORIAL DR",
            "address_2": "STE 403",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011063",
            "telephone_number": "574-647-1405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAN",
        "first_name": "MERCEDES",
        "middle_name": "DEL CARMEN",
        "credential": "CNM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-03",
        "last_updated": "2018-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MI",
            "license": "4704237039",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71004286A",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MI",
            "license": "4704237039",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "IN",
            "license": "71004286A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS BMG CENTRAL NEIGHBORHOOD HEALTH CTR",
            "identifier": "000000814990",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200530760",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS BMG CENTENNIAL NEIGHBORHOOD HEALTH CTR",
            "identifier": "000000815003",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS BMG SOUTHEAST NEIGHBORHOOD CTR",
            "identifier": "00000080642",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "236040264",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marissa Moore
• Nicole Renee Moore
• Patricia A Moore
• Tracey Moore
• Whitney Moore
• Tricia L Moreno, AUD
• Jordan P Morey, MS, LMHCA
• Mary Jo Morey, FNP-BC
• Mia Morgan-Perez
• Anne M Morgan, MA

• Advanced Practice Midwife in South Bend, IN
• Providers in South Bend, IN by specialty
• Advanced Practice Midwife in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.