Individual provider Active NPI

Victoria L Moyer, MD

  • Family Medicine Physician
  • Kokomo, IN
National Provider Identifier
1891776951
Registry record updated Oct 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01055871A Issued in IN
Practice address
138 N Dixon Rd
Kokomo, IN 46901-4154
Phone
(765) 236-8282
NPI assigned
Nov 7, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01055871A IN Primary

Addresses

Primary practice location

138 N Dixon Rd
Kokomo, IN 46901-4154

Mailing address

138 N Dixon Rd
Kokomo, IN 46901-4154

Other identifiers 3

IdentifierTypeStateIssuer
000000229465OtherANTHEM
200389350AMedicaidIN
10784616OtherCAQH

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
I20040324000092 IN Practitioner - Family Practice 2163313529 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Indiana University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Physicians of Indiana IncGroup PAC ID 1759416662, 1,569 clinicians

Practice addresses (Care Compare)

2401 Columbus Blvd
Kokomo, IN 46901-6455
Phone (765) 453-1254

Hospital & facility affiliations

  • Ascension at Home Home health agency, Pendleton, IN, CCN 157059
  • Community Howard Regional Health Inc. Hospital, Kokomo, IN, CCN 150007
  • Ascension St Vincent Kokomo Hospital, Kokomo, IN, CCN 150010

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01055871AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physicians of Indiana Inc CurrentSince Oct 1, 2022 Accepting new patients
Community Physicians of Indiana Inc Family Medicine CurrentSince Oct 1, 2022 Accepting new patients
Major Hospital Past Accepting new patients
Grace Divine, LLC Family Medicine PastSince Sep 6, 2024 Accepting new patients
St. Joseph Primary Care, LLC Family Medicine Past Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

2401 Columbus Blvd
Kokomo, IN 46901
Phone (765) 236-0786

Interoperability endpoints

  • Direct secure messaging: vmoyer546085@ecommunitydirect.com

Organizations & group practices 5

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 3

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": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664928000000",
    "number": "1891776951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 N DIXON RD",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469014154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 N DIXON RD",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469014154",
            "telephone_number": "765-236-8282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOYER",
        "first_name": "VICTORIA",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-07",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01055871A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000229465",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200389350A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "10784616",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kokomo, IN

Sources for this page

Verify at the official NPI Registry.