Individual provider Active NPI

Karolyn Kay Moody, DO

  • Emergency Medicine Physician
  • Tacoma, WA
National Provider Identifier
1467689000
Registry record updated May 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
0102203535 Issued in VA
Practice address
209 Martin Luther King Jr Way
Tacoma, WA 98405-4265
Phone
(253) 596-3300
Fax
(253) 596-3301
NPI assigned
Jun 22, 2009
Last updated
May 31, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X DO0000002474 TN
Emergency Medicine Physician 207P00000X 0102203535 VA Primary

Addresses

Primary practice location

209 Martin Luther King Jr Way
Tacoma, WA 98405-4265

Mailing address

100 15TH St NW
Norton, VA 24273-1616
Phone (276) 439-1100

Other practice location 1

100 15th St NW
Norton, VA 24273-1616
Phone (276) 439-1100

Other identifiers 2

IdentifierTypeStateIssuer
0102203535OtherVACOMMONWEALTH OF VIRGINIA
DO0000002474OtherTNSTATE OF TENNESSEE

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, TN, WA3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20140317001169 VA Practitioner - Emergency Medicine 1254562226 Reassigns benefits to 1 organization
I20150309002303 TN Practitioner - Emergency Medicine 1254562226 Reassigns benefits to 2 organizations
I20170629000952 WA Practitioner - Emergency Medicine 1254562226 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

700 Lilly Rd NE
Olympia, WA 98506-5115
Phone (360) 923-7000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DO0000002474TNMDEmergency Medicine Physician
2474TNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-Cities Regional Emergency Physicians, PC Emergency Medicine CurrentSince Apr 1, 2017 Accepting new patients
Lewis County Hospital District No 1 Current Accepting new patients
Tri-Cities Observation Services, PC Emergency Medicine CurrentSince Dec 16, 2017 Accepting new patients
Lewis County Hospital District No. 1 Emergency Medicine CurrentSince Aug 21, 2020 Accepting new patients
Blue Ridge Medical Management Corporation CurrentSince Feb 27, 2016 Accepting new patients
Public Hospital District No 1 of Mason County Wa CurrentSince Dec 2, 2020 Accepting new patients
Blue Ridge Medical Management Corporation Current Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Mar 24, 2023 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Mar 24, 2023 Accepting new patients
Lewis County Hospital District No. 1 CurrentSince Aug 21, 2020 Accepting new patients
Public Hospital District No 1 of Mason County CurrentSince Dec 2, 2020 Accepting new patients
Blue Ridge Medical Management Corporation CurrentSince Feb 27, 2016 Accepting new patients

Locations

1501 W Elk Ave
Elizabethton, TN 37643
Phone (423) 542-1300

400 N State of Franklin Rd
Johnson City, TN 37604
Phone (423) 323-6900

2000 Brookside Dr
Kingsport, TN 37660
Phone (423) 857-7144

323 Falls Dr NW
Abingdon, VA 24210
Phone (276) 628-2612

100 15th St NW
Norton, VA 24273
Phone (276) 439-1000

100 15th St NW
Ste A
Norton, VA 24273
Phone (276) 439-1840

700 Lilly Rd NE
Olympia, WA 98506
Phone (360) 923-7000

19379 7th Ave NE
Poulsbo, WA 98370
Phone (360) 394-1000

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

901 Mountain View Dr
Shelton, WA 98584
Phone (360) 426-1611

209 Martin Luther King Jr Way
Tacoma, WA 98405
Phone (253) 596-3300

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

Interoperability endpoints

  • Direct secure messaging: kmoody4229770@ghc.direct-ci.net

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1245628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685491200000",
    "number": "1467689000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 15TH ST NW",
            "city": "NORTON",
            "state": "VA",
            "postal_code": "242731616",
            "telephone_number": "276-439-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 MARTIN LUTHER KING JR WAY",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054265",
            "telephone_number": "253-596-3300",
            "fax_number": "253-596-3301"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 15th St NW",
            "address_purpose": "LOCATION",
            "city": "Norton",
            "state": "VA",
            "postal_code": "242731616",
            "country_code": "US",
            "telephone_number": "276-439-1100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOODY",
        "first_name": "KAROLYN",
        "middle_name": "KAY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-22",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "DO0000002474",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0102203535",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMONWEALTH OF VIRGINIA",
            "identifier": "0102203535",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF TENNESSEE",
            "identifier": "DO0000002474",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "209 Martin Luther King Jr Way",
            "city": "Tacoma",
            "state": "WA",
            "country_code": "US",
            "postal_code": "984054265",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.