Individual provider Active NPI

Kelsey Elizabeth Moore, APRN

  • Adult Health Nurse Practitioner
  • Marietta, GA
National Provider Identifier
1043563695
Registry record updated Oct 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
181455 Issued in GA
Practice address
1810 White Cir
Marietta, GA 30066-5835
Phone
(888) 837-4819
NPI assigned
Oct 19, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 181455 GA Primary

Addresses

Primary practice location

1810 White Cir
Marietta, GA 30066-5835

Mailing address

1796 Walker Ridge Dr SW
Marietta, GA 30064-4190
Phone (770) 853-6009

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170713000863 CO Practitioner - Nurse Practitioner 9032346184 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
181455GAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado Hospitalist Services, PLLC CurrentSince Jun 19, 2017 Accepting new patients
Colorado Hospitalist Services, PLLC CurrentSince Jun 19, 2017 Accepting new patients

Locations

4567 E 9th Ave
Denver, CO 80220
Phone (303) 302-2121

501 E Hampden Ave
Englewood, CO 80113
Phone (303) 788-5300

Organizations & group practices 2

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1350604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760659200000",
    "number": "1043563695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1796 WALKER RIDGE DR SW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300644190",
            "telephone_number": "770-853-6009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 WHITE CIR",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300665835",
            "telephone_number": "888-837-4819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "KELSEY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-19",
        "last_updated": "2025-10-17",
        "certification_date": "2025-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "181455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.