Active NPI
Susanna Moberly, APRN
- Rheumatology Physician
- Nicholasville, KY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rheumatology Physician
- License
- 3009443
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Women's Health Nurse Practitioner | 363LW0102X | 3009443 | KY | |
| Nurse Practitioner | 363L00000X | 3009443 | KY | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 3009443 | KY | |
| Rheumatology Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346035524 | Medicaid | KY | |
| 1568843316 | Medicaid | KY |
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
Enrollment records 1
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
| License | State | Type | Specialty |
|---|---|---|---|
| 3009443 | KY | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Only You Wellness | Multi-Specialty | Current | 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.
-
- Multi-Specialty Clinic/Center
- Nicholasville, KY
- NPI 1346035524
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Baptist Health Lexington
- General Acute Care Hospital
- Lexington, KY
- NPI 1538244918
-
dba Kentucky Laboratory System
- Clinical Medical Laboratory
- Lexington, KY
- NPI 1215227012
Hospital
-
dba CHI Saint Joseph Hospital
- General Acute Care Hospital
- Lexington, KY
- NPI 1437150984
-
dba CHI Saint Joseph Jessamine
- Clinic/Center
- Nicholasville, KY
- NPI 1861650814
Hospital
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2025; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.