Individual provider Active NPI

Emmanuel Moses-Fynn, DO

  • Internal Medicine Physician
  • Evansville, IN
National Provider Identifier
1831943539
Registry record updated Jul 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
11023972A Issued in IN
Practice address
801 Saint Marys Dr Ste 300
Evansville, IN 47714-0511
Phone
(812) 485-5300
Fax
(812) 485-1775
NPI assigned
Apr 17, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 11023972A IN Primary

Addresses

Primary practice location

801 Saint Marys Dr Ste 300
Evansville, IN 47714-0511

Mailing address

801 Saint Marys Dr Ste 510
Evansville, IN 47714-0511
Phone (812) 485-5990

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250718001578 IN Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 4284140138

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
11023972AINMDInternal Medicine Physician

Interoperability endpoints

  • Direct secure messaging: emmanuel.moses-fynn.1@7598.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1713312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782864000000",
    "number": "1831943539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 SAINT MARYS DR STE 510",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477140511",
            "telephone_number": "812-485-5990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 SAINT MARYS DR STE 300",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477140511",
            "telephone_number": "812-485-5300",
            "fax_number": "812-485-1775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSES-FYNN",
        "first_name": "EMMANUEL",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-17",
        "last_updated": "2026-07-01",
        "certification_date": "2026-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "11023972A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.