Individual provider Active NPI

Kayla Anglin Moore, NP-C

  • Adult Medicine Physician
  • Grenada, MS
National Provider Identifier
1578082137
Registry record updated Jul 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
902287 Issued in MS
Practice address
960 Avent Dr # 3W
Grenada, MS 38901-5230
Phone
(662) 227-7793
Fax
(662) 227-7723
NPI assigned
Sep 14, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X 902287 MS
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 902287 MS
Adult Medicine Physician 207QA0505X 902287 MS Primary

Addresses

Primary practice location

960 Avent Dr # 3W
Grenada, MS 38901-5230

Mailing address

506 Highway 330
Bruce, MS 38915-9594
Phone (662) 542-1477

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20171020000544 MS Practitioner - Nurse Practitioner 7214203108 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

Practice addresses (Care Compare)

960 Avent Dr
Grenada, MS 38901-5230
Phone (662) 227-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.94 of 100Reported as group
Quality
67.75
Promoting interoperability
100
Improvement activities
40
Cost
71.17

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Dec 6, 2023 Accepting new patients
State of Mississippi - University of Mississippi Medical Center Current Accepting new patients
State of Mississippi-University of Mississippi Medical Center CurrentSince Dec 6, 2023 Accepting new patients
University Physicians, PLLC Past Accepting new patients

Locations

504 Clinton Center Dr
Ste 4300
Clinton, MS 39056

965 Avent Dr
Ste 100A
Grenada, MS 38901
Phone (662) 227-7000

960 Avent Dr
#J
Grenada, MS 38901
Phone (662) 227-6450

960 Avent Dr
#3W
Grenada, MS 38901

960 Avent Dr
#3
Grenada, MS 38901

830 S Gloster St
Tupelo, MS 38801
Phone (662) 377-3136

Interoperability endpoints

  • Direct secure messaging: kmoore192184@ummc.direct-ci.com

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1505347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784246400000",
    "number": "1578082137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 HIGHWAY 330",
            "city": "BRUCE",
            "state": "MS",
            "postal_code": "389159594",
            "telephone_number": "662-542-1477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 AVENT DR # 3W",
            "city": "GRENADA",
            "state": "MS",
            "postal_code": "389015230",
            "telephone_number": "662-227-7793",
            "fax_number": "662-227-7723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "KAYLA",
        "middle_name": "ANGLIN",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-14",
        "last_updated": "2026-07-17",
        "certification_date": "2026-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "MS",
            "license": "902287",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MS",
            "license": "902287",
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "MS",
            "license": "902287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grenada, MS

Sources for this page

Verify at the official NPI Registry.