Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Alyssa Marie Moon

Individual provider Nurse Practitioner · NPI 1497534630

Alyssa Marie Moon is a Nurse Practitioner in Kokomo, Indiana. Qualified in 2023, 3 years ago. Practices with Memorial Hospital, a 63-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
3
Licensed in
IN
In the registry since
2023
Specialties on file
2
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

138 N Dixon Rd
Kokomo, IN 46901-4154
Phone: (765) 236-8282
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1101 Michigan Ave, Logansport, IN 46947-1528 — (765) 753-0867

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 71014484A (IN)
Nurse Practitioner Taxonomy 363L00000X · Licence 18004578283 (IN)

Record details

NPI number1497534630
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedSeptember 27, 2023
Last updated in NPPESNovember 11, 2024
Certification dateNovember 11, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Memorial Hospital — 63 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Kokomo