Kody A Moffatt, M.D.

Primary specialty

Pediatric Sports Medicine PhysicianTaxonomy code 2080S0010X

License

21839 Issued in NE

Practice address

20502 Roosevelt St
Elkhorn, NE 68022-4148

Phone

(402) 955-7529

Fax

(402) 955-6529

NPI assigned

Aug 31, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kmoffatt1208@direct.chsomaha.org

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.

• Children'S Specialty Physician Billing

  • Pediatric Nurse Practitioner
  • Omaha, NE
  • NPI 1013040369
  NPD (past)
• Nebraska Pediatric Practice, Inc

  • Pediatrics Physician
  • Omaha, NE
  • NPI 1144556333
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764028800000",
    "number": "1124139043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 CALIFORNIA PLZ",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681780001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20502 ROOSEVELT ST",
            "city": "ELKHORN",
            "state": "NE",
            "postal_code": "680224148",
            "telephone_number": "402-955-7529",
            "fax_number": "402-955-6529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOFFATT",
        "first_name": "KODY",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080S0010X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sports Medicine",
            "state": "NE",
            "license": "21839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony Robert Milone, PTA
• Mia Minor
• Kristina Minturn
• Taylor Miranda
• Keygan Misek
• Saria Mohammed
• Edward P Montanez, M.D.
• Madison Paige Montgomery
• Val Moody
• Danielle Moore

• Pediatric Sports Medicine Physician in Elkhorn, NE
• Providers in Elkhorn, NE by specialty
• Pediatric Sports Medicine Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.