Individual provider Active NPI

Susanna Moberly, APRN

  • Rheumatology Physician
  • Nicholasville, KY
National Provider Identifier
1568843316
Registry record updated Dec 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
3009443 Issued in KY
Practice address
459 Keene Centre Dr
Nicholasville, KY 40356-1492
Phone
(859) 241-1136
Fax
(859) 241-1009
NPI assigned
Jun 17, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 3009443 KY
Nurse Practitioner 363L00000X 3009443 KY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 3009443 KY
Rheumatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RR0500X 3009443 KY Primary

Addresses

Primary practice location

459 Keene Centre Dr
Nicholasville, KY 40356-1492

Mailing address

459 Keene Centre Dr
Nicholasville, KY 40356-1492
Phone (859) 241-1136

Other identifiers 2

IdentifierTypeStateIssuer
1346035524MedicaidKY
1568843316MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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

Enrollment IDStateProvider typePAC IDDetails
I20150729008788 KY Practitioner - Nurse Practitioner 6901110303 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

459 Keene Centre Dr
Nicholasville, KY 40356-1492
Phone (859) 241-1136

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3009443KYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Only You Wellness Multi-Specialty CurrentSince May 1, 2024 Accepting new patients

Locations

617 Edgewood Dr
Nicholasville, KY 40356

459 Keene Centre Dr
Nicholasville, KY 40356
Phone (859) 241-1136

Organizations & group practices 1

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1434499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765324800000",
    "number": "1568843316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "459 KEENE CENTRE DR",
            "city": "NICHOLASVILLE",
            "state": "KY",
            "postal_code": "403561492",
            "telephone_number": "859-241-1136",
            "fax_number": "859-241-1009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "459 KEENE CENTRE DR",
            "city": "NICHOLASVILLE",
            "state": "KY",
            "postal_code": "403561492",
            "telephone_number": "859-241-1136",
            "fax_number": "859-241-1009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOBERLY",
        "first_name": "SUSANNA",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-17",
        "last_updated": "2025-12-10",
        "certification_date": "2025-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "KY",
            "license": "3009443",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3009443",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "3009443",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": "KY",
            "license": "3009443",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1346035524",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1568843316",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nicholasville, KY

Sources for this page

Verify at the official NPI Registry.