Individual provider Active NPI

Kathryn D Moulton-Gray, ARNP

  • Family Nurse Practitioner
  • Brooksville, FL
National Provider Identifier
1083994248
Registry record updated Apr 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP3016842 Issued in FL
Practice address
12083 Cortez Blvd
Brooksville, FL 34613-7350
Phone
(352) 596-4022
Fax
(352) 596-9851
NPI assigned
Aug 19, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN3016842 FL
Family Nurse Practitioner 363LF0000X ARNP3016842 FL Primary

Addresses

Primary practice location

12083 Cortez Blvd
Brooksville, FL 34613-7350

Mailing address

5350 Spring Hill Dr
Spring Hill, FL 34606-4562
Phone (352) 277-5348

Other practice location 1

92 Cypress Blvd W
Homosassa, FL 34446-4562
Phone (352) 765-4737

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20120920000356 FL Practitioner - Nurse Practitioner 7214185016 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
22.95 of 100Reported as group
Quality
0
Promoting interoperability
0
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN3016842FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Access Health Care LLC Past Accepting new patients
Unity Healthcare LLC Past Accepting new patients
Osteopathic Heritage, P.a. PastSince Aug 1, 2019 Accepting new patients

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JICADA

Organizations & group practices 4

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": "1313712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777248000000",
    "number": "1083994248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5350 SPRING HILL DR",
            "city": "SPRING HILL",
            "state": "FL",
            "postal_code": "346064562",
            "telephone_number": "352-277-5348",
            "fax_number": "352-606-2857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12083 CORTEZ BLVD",
            "city": "BROOKSVILLE",
            "state": "FL",
            "postal_code": "346137350",
            "telephone_number": "352-596-4022",
            "fax_number": "352-596-9851"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "92 Cypress Blvd W",
            "address_purpose": "LOCATION",
            "city": "Homosassa",
            "state": "FL",
            "postal_code": "344464562",
            "country_code": "US",
            "telephone_number": "352-765-4737",
            "fax_number": "352-503-6868",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOULTON-GRAY",
        "first_name": "KATHRYN",
        "middle_name": "D",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-19",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "RN3016842",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP3016842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooksville, FL

Sources for this page

Verify at the official NPI Registry.