Kelly Moore, APRN

Primary specialty

Community Health Nurse PractitionerTaxonomy code 363LC1500X

License

065266-23 Issued in NH

Practice address

311 Route 108
Somersworth, NH 03878-1522

Phone

(603) 749-2346

NPI assigned

Oct 7, 2011

Last updated

Mar 15, 2021By 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NH

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• South Bay Mental Health Center

  • Community/Behavioral Health Agency
  • Lowell, MA
  • NPI 1790092088
  NPD (past)

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

{
    "created_epoch": "1317945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615766400000",
    "number": "1477837516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 ROUTE 108",
            "city": "SOMERSWORTH",
            "state": "NH",
            "postal_code": "038781522",
            "telephone_number": "603-749-2346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 ROUTE 108",
            "city": "SOMERSWORTH",
            "state": "NH",
            "postal_code": "038781522",
            "telephone_number": "603-749-2346"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Campus Dr",
            "address_purpose": "LOCATION",
            "city": "Portsmouth",
            "state": "NH",
            "postal_code": "038015892",
            "country_code": "US",
            "telephone_number": "603-422-8208",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "KELLY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-07",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LC1500X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Community Health",
            "state": "NH",
            "license": "065266-23",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NH",
            "license": "065266-23",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NH",
            "license": "065266-23",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN LICENSE",
            "identifier": "065266-23",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tatjana Milosavljevic, PT
• Sharanjeet Minhas
• Mohamed Hassan Mohamed
• Steven Molnar-Gabor, MD
• Mark Mooradian, PA-C
• Maria Morello, PT, DPT
• Niki-Lynn Moriarty, PHARMD
• Harry Robert Morse, CRNA
• April Mroz
• Barbara Nadeau, PA

• Community Health Nurse Practitioner in Somersworth, NH
• Providers in Somersworth, NH by specialty
• Community Health Nurse Practitioner in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.