Active NPI
Vanessa Marie Moore, AGPCNP
- Nurse Practitioner
- Brownsburg, IN
National Provider Identifier
1770298010
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 71012652A
- Practice address
- 14 E Main St
Brownsburg, IN 46112-1214 - Phone
- (317) 979-9652
- NPI assigned
- Jan 20, 2023
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 71012652A | IN | Primary |
Addresses
Primary practice location
14 E Main St
Brownsburg, IN 46112-1214
Mailing address
6075 Brookshire Dr
Pittsboro, IN 46167-9305
Phone (317) 979-9652
Other practice location 1
6075 Brookshire Dr
Pittsboro, IN 46167-9305
Phone (317) 979-9652
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71012652A | IN | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1674172800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674172800000",
"number": "1770298010",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6075 BROOKSHIRE DR",
"city": "PITTSBORO",
"state": "IN",
"postal_code": "461679305",
"telephone_number": "317-979-9652"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14 E MAIN ST",
"city": "BROWNSBURG",
"state": "IN",
"postal_code": "461121214",
"telephone_number": "317-979-9652"
}
],
"practiceLocations": [
{
"address_1": "6075 Brookshire Dr",
"address_purpose": "LOCATION",
"city": "Pittsboro",
"state": "IN",
"postal_code": "461679305",
"country_code": "US",
"telephone_number": "317-979-9652",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MOORE",
"first_name": "VANESSA",
"middle_name": "MARIE",
"credential": "AGPCNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-01-20",
"last_updated": "2023-01-20",
"certification_date": "2023-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IN",
"license": "71012652A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brownsburg, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.