Gina L Moore, FNP
Individual provider Active NPI Family Nurse Practitioner · Argos, IN
NPI 1992786248 · NPPES record last updated Oct 2, 2014
Key facts
- NPI
- 1992786248
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 71001226A (IN)
- Practice address
- 530 N Michigan St
Argos, IN 46501-1134 - Phone
- (574) 892-5131
- Fax
- (574) 223-5847
- NPI assigned
- Nov 11, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 18
Hospital & facility affiliations 8
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Woodlawn Hospital
Practice addresses (Care Compare)
530 N Michigan
Argos Medical Center
Argos, IN 46501-1134
Phone (574) 892-5131
Hospital & facility affiliations
- Home Health Care Solutions LLC
- Woodlawn Hospital
- Saint Joseph Regional Medical Center - Plymouth
- Community Hospital of Bremen Inc
- Memorial Hospital of South Bend
- Northwest Health - Starke
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
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080312000258 | IN | Practitioner - Nurse Practitioner | 9537244710 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Woodlawn Hospital | Current |
Accepting new patients | |
| Woodlawn Hospital | Current |
Accepting new patients | |
| Woodlawn Hospital | Current |
Accepting new patients | |
| Byron M. Holm, MD | Past | Accepting new patients | |
| Woodlawn Hospital | Past | Accepting new patients |
Locations
530 N Michigan St
Argos, IN 46501
Phone (574) 892-5131
1400 E 9th St
Rochester, IN 46975
Phone (574) 223-2020
Interoperability endpoints
- gmoore116675@direct.parkviewexchange.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 71001226A | IN | Yes |
Addresses
Primary practice location
530 N Michigan St
Argos, IN 46501-1134
Mailing address
1400 E 9TH St
Rochester, IN 46975-8931
Phone (574) 224-1044
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200862210 | Medicaid | IN |
Other providers in Argos, IN
- Michael Evan Dixon
- Shannon Michelle Guckien
- John L Haste
- Elizabeth Ann Holsopple
- Timothy Jeffirs
- Christopher M Ricketts
- Road Apple Psychotherapy
- Debra F Sanders
- Jennifer L Shank
- Town of Argos
All providers in Argos, IN · Family Nurse Practitioner in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 2, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.