Omega Medical and Aesthetics PLLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

OMEGA MEDICAL AND AESTHETICS PLLC

Practice address

239 Clifford Price Loop
Mooresburg, TN 37811-2337

Phone

(978) 906-0418

NPI assigned

Aug 5, 2025

Last updated

Nov 7, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Susan KellyNPI 1992265003

Title

Owner, NP

Phone

(423) 754-9648

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Susan Elizabeth Kelly, FNP

  • Family Nurse Practitioner
  • Mooresburg, TN
  • NPI 1992265003
  Medicare reassignment NPD Authorized official
• Kellie Brooke Miralles

  • Family Nurse Practitioner
  • Morristown, TN
  • NPI 1346110160
  NPD
• Reinaldo Felix Miralles

  • Family Nurse Practitioner
  • Morristown, TN
  • NPI 1780554501
  NPD

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

{
    "created_epoch": "1754352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762473600000",
    "number": "1578447181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "239 CLIFFORD PRICE LOOP",
            "city": "MOORESBURG",
            "state": "TN",
            "postal_code": "378112337",
            "telephone_number": "423-839-0036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 CLIFFORD PRICE LOOP",
            "city": "MOORESBURG",
            "state": "TN",
            "postal_code": "378112337",
            "telephone_number": "978-906-0418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMEGA MEDICAL AND AESTHETICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-05",
        "last_updated": "2025-11-07",
        "certification_date": "2025-11-07",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "OWNER, NP",
        "authorized_official_telephone_number": "423-754-9648"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Eli Gass
• Susan Elizabeth Kelly, FNP
• James F Kresse, MLDT-CLT
• Cassandra Mishurda
• Selena Marilyn Morris, CNA
• Joshua Proffitt, MD
• Rocky Top Family Med, Inc
• Brent Matthew Smith, RN
• Mary Virginia Stewart, CDCA
• Rebekah Lee Thompson, RBT

• Family Nurse Practitioner in Mooresburg, TN
• Providers in Mooresburg, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.