Khamphou Manivanh Mosley, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN11002153 Issued in FL

Practice address

1100 N Parrott Ave
Okeechobee, FL 34972-2129

Phone

(863) 763-7481

Fax

(844) 542-4899

NPI assigned

May 15, 2018

Last updated

Jun 25, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Florida Community Health Centers IncGroup PAC ID 9931017126, 32 clinicians

Florida Kidney Physicians LLCGroup PAC ID 4385925650, 167 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventhealth Port Charlotte Hospital, Port Charlotte, FL, CCN 100077

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/15644/brand/1/csg/1/fhir/r4
• Direct secure messaging: khamphou.mosley.1@14865.direct.athenahealth.com
• Direct secure messaging: khamphou.mosley.1@15644.direct.athenahealth.com
• Direct secure messaging: khamphou.mosley@hca4.eclinicaldirectplus.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Florida Community Health Centers Inc

  • Family Medicine Physician
  • Pahokee, FL
  • NPI 1851518211
  Medicare reassignment Care Compare group NPD
• Florida Kidney Physicians, LLC

  • Nephrology Physician
  • Temple Terrace, FL
  • NPI 1760831564
  Medicare reassignment Care Compare group NPD
• Florida Community Health Centers Inc

  • Family Medicine Physician
  • Clewiston, FL
  • NPI 1124078571
  NPD
• Florida Community Health Centers Inc

  • Federally Qualified Health Center (FQHC)
  • Moore Haven, FL
  • NPI 1194071944
  NPD
• Florida Community Health Centers Inc

  • Federally Qualified Health Center (FQHC)
  • Port St Lucie, FL
  • NPI 1215986872
  NPD
• Florida Community Health Centers Inc

  • Family Medicine Physician
  • Okeechobee, FL
  • NPI 1952351306
  NPD
• Florida Kidney Physicians , LLC

  • Nephrology Physician
  • Melbourne, FL
  • NPI 1205506722
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Adventhealth Port Charlotte Inc

  dba Adventhealth Port Charlotte

  • General Acute Care Hospital
  • Port Charlotte, FL
  • NPI 1760299093
  Care Compare affiliation

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

{
    "created_epoch": "1526342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1093205049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5827 CORPORATE WAY",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334072000",
            "telephone_number": "561-844-9443",
            "fax_number": "561-472-9692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 N PARROTT AVE",
            "city": "OKEECHOBEE",
            "state": "FL",
            "postal_code": "349722129",
            "telephone_number": "863-763-7481",
            "fax_number": "844-542-4899"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2636 Elm Hill Pike",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372143162",
            "country_code": "US",
            "telephone_number": "347-761-3230",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10130 Perimeter Pkwy Ste 200",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282160197",
            "country_code": "US",
            "telephone_number": "888-849-7379",
            "fax_number": "855-857-7333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOSLEY",
        "first_name": "KHAMPHOU",
        "middle_name": "MANIVANH",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-15",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "21726",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5010768",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11002153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Molyneaux, LCSW, ACSW
• Julian A Moore, M.D.
• Alexis Ann Morgan
• Darby B Morgan, ARNP
• Melissa Kathryn Morris, ARNP
• Philip Moyer, M.D.
• Kim C Mucherino, PHARM D
• Muhammad a Chaudhary MD PA
• Muhammad K Syed MD PA - Pharmacy
• Muhammad K Syed, MD, PA (Indiantown Medical Center)

• Family Nurse Practitioner in Okeechobee, FL
• Providers in Okeechobee, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.