NPIMap

Individual provider Active NPI

Dana L Moore, FNP-BC

  • Family Nurse Practitioner
  • Carmel, IN
National Provider Identifier
1851553721
Registry record updated Jul 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71004048A Issued in IN
Practice address
310 Medical Dr Ste 101
Carmel, IN 46032-3078
Phone
(317) 415-6350
NPI assigned
Jul 1, 2008
Last updated
Jul 26, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 28202357A IN
Nurse Practitioner 363L00000X 71004048A IN
Family Nurse Practitioner 363LF0000X 71004048A IN Primary

Addresses

Primary practice location

310 Medical Dr Ste 101
Carmel, IN 46032-3078

Mailing address

310 Medical Dr Ste 101
Carmel, IN 46032-3078

Other names 1

  • Dana Kingma Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dana.moore.1@7598.direct.athenahealth.com St. Vincent Medical Group, Inc.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120803000600 IN Practitioner - Nurse Practitioner 0749354785 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Vincent Medical Group IncGroup PAC ID 7012047640, 728 clinicians

Practice addresses (Care Compare)

310 Medical Dr
Suite 101
Carmel, IN 46032-3078
Phone (317) 415-6350

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28202357AINMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Major Hospital Past Accepting new patients
Elmhurst Memorial Healthcare PastSince May 25, 2021 Accepting new patients
St Vincent Medical Group Inc Past Accepting new patients

Organizations & group practices 4

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1214870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658793600000",
    "number": "1851553721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 MEDICAL DR STE 101",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460323078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 MEDICAL DR STE 101",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460323078",
            "telephone_number": "317-415-6350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "DANA",
        "middle_name": "L",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-01",
        "last_updated": "2022-07-26",
        "certification_date": "2022-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28202357A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71004048A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71004048A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dana.moore.1@7598.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "St. Vincent Medical Group, Inc.",
            "address_1": "310 Medical Dr Ste 101",
            "city": "Carmel",
            "state": "IN",
            "country_code": "US",
            "postal_code": "460323078",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "DANA",
            "last_name": "KINGMA",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Carmel, IN

Sources for this page

Verify at the official NPI Registry.