Individual provider Active NPI

Denise Elizabeth Moroz, APRN

  • Nurse Practitioner
  • Kingsland, GA
National Provider Identifier
1467947838
Registry record updated Jun 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN167793 Issued in GA
Practice address
1481 Hwy 40 E
Kingsland, GA 31548-6507
Phone
(912) 576-6865
NPI assigned
Jun 27, 2018
Last updated
Jun 27, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN167793 GA Primary

Addresses

Primary practice location

1481 Hwy 40 E
Kingsland, GA 31548-6507

Mailing address

1481 Hwy 40 E
Kingsland, GA 31548-6507

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180814001994 GA Practitioner - Nurse Practitioner 4082963723 Reassigns benefits to 1 organization
I20220607000012 FL Practitioner - Nurse Practitioner 4082963723 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Amelia Medical Services LLCGroup PAC ID 1052530029, 3 clinicians
Amelia Urgent Care LLCGroup PAC ID 6608877915, 3 clinicians

Practice addresses (Care Compare)

3435 2ND St S
Folkston, GA 31537-8447
Phone (912) 496-0041

96279 Brady Point Rd
Fernandina Beach, FL 32034-7076
Phone (904) 321-0088

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN167793GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Amelia Medical Services, LLC CurrentSince May 3, 2022 Accepting new patients
Amelia Urgent Care LLC CurrentSince Feb 23, 2022 Accepting new patients
Amelia Urgent Care LLC CurrentSince Feb 23, 2022 Accepting new patients
Amelia Medical Services, LLC Current Accepting new patients

Locations

96279 Brady Point Rd
Fernandina Beach, FL 32034
Phone (904) 321-0088

510 Airport Center Dr
Ste 109
Jacksonville, FL 32218
Phone (904) 636-0055

3435 Second St S
Folkston, GA 31537
Phone (912) 390-0058

1481 Highway 40 E
Kingsland, GA 31548
Phone (912) 576-2565

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, 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": "1530057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530057600000",
    "number": "1467947838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1481 HWY 40 E",
            "city": "KINGSLAND",
            "state": "GA",
            "postal_code": "315486507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1481 HWY 40 E",
            "city": "KINGSLAND",
            "state": "GA",
            "postal_code": "315486507",
            "telephone_number": "912-576-6865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOROZ",
        "first_name": "DENISE",
        "middle_name": "ELIZABETH",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-27",
        "last_updated": "2018-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN167793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsland, GA

Sources for this page

Verify at the official NPI Registry.