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KEVIN NELSON MOORE PMHNP-BC, APRN
NPI 1710479753
Nurse Practitioner - Psychiatric/Mental Health in Bloomington, IN

Active since June 05, 2018PECOS Enrolled
501 S MADISON ST STE 105, BLOOMINGTON, IN 47403(812) 340-5447(888) 789-8394 Get Directions Write a Review

NPPES record last updated: February 21, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 7, 2020, Nov 20, 2020, Jul 3, 2019 (3 updates tracked since 2019).

About Kevin Nelson Moore Pmhnp-bc, Aprn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KEVIN NELSON MOORE PMHNP-BC, APRN (NPI 1710479753) is an individual psychiatric/mental health provider in Bloomington, Indiana, licensed in Indiana (71008478A) and active in the NPI registry since June 2018. He is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1710479753
Entity TypeIndividualMale
Primary Taxonomy363LP0808X
Provider Legal NameKEVIN NELSON MOORECredential: PMHNP-BC, APRN
Location Address501 S MADISON ST STE 105Bloomington, IN 47403-2452
Mailing Address501 S Madison St Ste 105Bloomington, IN 47403-2452 · (812) 340-5547 · Fax (888) 789-8394
Phone(812) 340-5447
Fax(888) 789-8394
Sole ProprietorNo
Enumeration DateJune 5, 2018
Last NPPES UpdateFebruary 21, 20243 updates tracked since enumeration
NPPES CertifiedFebruary 3, 2021
✔ NPI 1710479753 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in IN · 71008478A
501 S MADISON ST STE 105, Bloomington, IN 47403
Open in Google Maps ↗

Secondary Practice Locations 2

Location 1550 S Adams StBloomington, IN 47403 · Phone (812) 333-6324 · Fax (812) 331-6700
Location 21531 13th St Ste 2520Columbus, IN 47201-1312 · Phone (812) 376-6501

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kevin Nelson Moore Pmhnp-bc, Aprn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 47403 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$82.04 typical visit price
range $53.07 – $161.76
Typical copayment $20.51 (range $13.26 – $40.44)
Most-billed visit code 99203
Established Patient
$94.22 typical visit price
range $16.93 – $132.22
Typical copayment $23.55 (range $4.23 – $33.05)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JULIE CHAPIN PH.D, HSPP
Psychologist (Clinical)
501 S MADISON ST STE 105
BLOOMINGTON, IN 47403
Monroe County (812) 322-7074
EMMA MARSCHEL RBT
Behavior Technician
501 S MADISON ST STE 105
BLOOMINGTON, IN 47403
Monroe County (812) 322-0313
KYLE S FOUCH APRN
Nurse Practitioner (Psychiatric/Mental Health)
501 S MADISON ST STE 105
BLOOMINGTON, IN 47403
Monroe County (812) 929-2193
CAMRYN SEXTON RBT
Behavior Technician
501 S MADISON ST STE 105
BLOOMINGTON, IN 47403
Monroe County (812) 322-0313
ADRIENNE S WATKINS RDN
Dietitian, Registered
501 S MADISON ST STE 105
BLOOMINGTON, IN 47403
Monroe County (812) 929-2193
VINCENT ALBRIGHT RBT
Behavior Technician
501 S MADISON ST STE 105
BLOOMINGTON, IN 47403
Monroe County (812) 322-0313
KAVYA KUMAR RBT
Behavior Technician
501 S MADISON ST STE 105
BLOOMINGTON, IN 47403
Monroe County (812) 322-0313
SYDNEY NICOLE CONGER
Student in an Organized Health Care Education/Training Program
501 S MADISON ST STE 105
BLOOMINGTON, IN 47403
Monroe County (812) 929-2193

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kevin Moore's NPI number?

The NPI number for Kevin Moore is 1710479753. It was assigned to this individual provider in the NPPES registry on June 5, 2018.

Where is Kevin Moore located?

Kevin Moore practices at 501 S Madison St Ste 105, Bloomington, IN 47403. The listed phone number is (812) 340-5447.

What is Kevin Moore's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Kevin Moore enrolled in Medicare?

Yes. Kevin Moore is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kevin Moore was last updated on February 21, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.