Elizabeth June Fish Moats, FNP

Key facts

NPI

1962050146

Entity type

Individual (NPI type 1)

Primary specialty

Family Nurse Practitioner 363LF0000X

License

71009271A (IN)

Practice address

2451 Intelliplex Dr
Shelbyville, IN 46176-8580

Phone

(317) 392-3211

NPI assigned

Aug 30, 2019

Sex

Female

Sole proprietor

Yes

Organizations & group practices 6

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.

• Brookside Medical Home Visits LLC Family Nurse Practitioner · Clay City, IN · NPI 1306339742
  Medicare reassignment Care Compare group NPD IN · SINGLE SPECIALTY
• Major Hospital General Acute Care Hospital · Shelbyville, IN · NPI 1174555692
  Medicare reassignment NPD IN · SINGLE SPECIALTY
• Brookside Medical Home Visits LLC Durable Medical Equipment & Medical Supplies · Carmel, IN · NPI 1770340051
  NPD
• Major Hospital Rural Health Clinic/Center · Shelbyville, IN · NPI 1689421554
  NPD
• X-Ray Physicians of Shelbyville PC Diagnostic Radiology Physician · Shelbyville, IN · NPI 1144351347
  NPD SINGLE SPECIALTY
• Indiana University Health Care Associates, Inc General Practice Physician · Indianapolis, IN · NPI 1902032832
  NPD (past) SINGLE SPECIALTY

Hospital & facility affiliations 3

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

• Major Hospital General Acute Care Hospital · Shelbyville, IN · NPI 1174555692
  Care Compare affiliation Hospital
• Rush Memorial Hospital Critical Access Hospital · Rushville, IN · NPI 1497726020
  Care Compare affiliation Hospital
• Suburban Home Health, LLC Home Health Agency · Noblesville, IN · NPI 1598872939
  Care Compare affiliation Home health agency

Medicare Care Compare profile

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Major Hospital (100 clinicians)
Brookside Medical Home Visits LLC (8 clinicians)

Practice addresses (Care Compare)

Hospital & facility affiliations

• Suburban Home Health LLC Home health agency · Noblesville, IN · CCN 157092
• Major Hospital Hospital · Shelbyville, IN · CCN 150097
• Rush Memorial Hospital Hospital · Rushville, IN · CCN 151304

Medicare participation

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: efishmoats7129@direct.eskenazihealth.edu
• Direct secure messaging: elizabeth.moats.1@28056.direct.athenahealth.com

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 15, 2021.

{
    "created_epoch": "1567123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634256000000",
    "number": "1962050146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 W RAMPART ST STE 200",
            "city": "SHELBYVILLE",
            "state": "IN",
            "postal_code": "461768846",
            "telephone_number": "317-421-2012",
            "fax_number": "317-398-1851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2451 INTELLIPLEX DR",
            "city": "SHELBYVILLE",
            "state": "IN",
            "postal_code": "461768580",
            "telephone_number": "317-392-3211"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "720 Eskenazi Ave Fl 4",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462025189",
            "country_code": "US",
            "telephone_number": "317-880-6868",
            "fax_number": "317-880-0439",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOATS",
        "first_name": "ELIZABETH",
        "middle_name": "JUNE FISH",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-30",
        "last_updated": "2021-10-15",
        "certification_date": "2021-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71009271A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Shelbyville, IN · Family Nurse Practitioner in Indiana