Individual provider Active NPI

Brian Keith Moore, APRN

  • Family Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1831416502
Registry record updated Oct 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4005867 Issued in KY
Practice address
6420 Dutchmans Pkwy Ste 200
Louisville, KY 40205-3373
Phone
(502) 891-8300
Fax
(502) 891-8338
NPI assigned
Apr 21, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN3117322 FL
Family Nurse Practitioner 363LF0000X 4005867 KY Primary

Addresses

Primary practice location

6420 Dutchmans Pkwy Ste 200
Louisville, KY 40205-3373

Mailing address

PO Box 776351
Chicago, IL 60677-6351
Phone (502) 588-9490

Other practice location 1

5151 N 9th Ave Ste 200
Pensacola, FL 32504-8721
Phone (850) 416-4970

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20240417000113 KY Practitioner - Nurse Practitioner 8527198738 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Medical Associates IncGroup PAC ID 7012811284, 1,368 clinicians

Practice addresses (Care Compare)

6420 Dutchmans Pkwy
Suite 200
Louisville, KY 40205-3373
Phone (502) 891-8300

Hospital & facility affiliations

  • Norton Hospitals, Inc Hospital, Louisville, KY, CCN 180088
  • Norton Clark Hospital Hospital, Jeffersonville, IN, CCN 150009

Merit-based Incentive Payment System (MIPS)

Final score
81.11 of 100Reported as group
Quality
63.34
Promoting interoperability
100
Improvement activities
40
Cost
73.68

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4005867KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Associates, Inc. Nurse Practitioner CurrentSince Feb 5, 2024 Accepting new patients
Community Medical Associates, Inc. Nurse Practitioner CurrentSince Feb 5, 2024 Accepting new patients
Community Medical Associates, Inc. Nurse Practitioner Current Accepting new patients

Locations

6420 Dutchmans Pkwy
Ste 200
Louisville, KY 40205
Phone (502) 891-8333

825 Barret Ave
Louisville, KY 40204
Phone (502) 272-5165

Interoperability endpoints

  • Direct secure messaging: bmoore277765@direct.nortonhealthcare.org

Organizations & group practices 3

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 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1271808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698278400000",
    "number": "1831416502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776351",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776351",
            "telephone_number": "502-588-9490",
            "fax_number": "502-272-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6420 DUTCHMANS PKWY STE 200",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402053373",
            "telephone_number": "502-891-8300",
            "fax_number": "502-891-8338"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5151 N 9th Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Pensacola",
            "state": "FL",
            "postal_code": "325048721",
            "country_code": "US",
            "telephone_number": "850-416-4970",
            "fax_number": "850-416-4969",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "BRIAN",
        "middle_name": "KEITH",
        "name_prefix": "Mr.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-21",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN3117322",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "4005867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.