Kelley Brown Moore

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

568 Issued in FL

Practice address

217 SE 1St Ave
Ocala, FL 34471-2161

Phone

(352) 877-9779

NPI assigned

Aug 22, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Rise Home Supports LLC

  • Home Health Agency
  • Ocala, FL
  • NPI 1366160640
  NPD Authorized official

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

{
    "created_epoch": "1661126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661126400000",
    "number": "1609594985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 SE 1ST AVE",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344712161",
            "telephone_number": "352-877-9779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 SE 1ST AVE",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344712161",
            "telephone_number": "352-877-9779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN MOORE",
        "first_name": "KELLEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-22",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "FL",
            "license": "PN1242581",
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": "568",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOME HEALTH AGENCY  EXEMPTION LICENSE",
            "identifier": "568",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Ceo@risehomesupportservices.co",
            "affiliation": "N",
            "address_1": "217 SE 1st Ave",
            "city": "Ocala",
            "state": "FL",
            "country_code": "US",
            "postal_code": "344712161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Joshua Brosius, M.DIV
• Michele Lee Brotherton, PHARM D.
• Victor Brotherton
• Ruth E. Brouwer, PA-C
• Suzette Cayea Brower, RPH
• Brown-Knight Reliable Transportation, LLC
• Amy Brown, L.M.T.
• Beverly Delores Brown, CAREGIVER
• Brian Christopher Brown
• Carroll Brown, PAC

• Home Health Agency in Ocala, FL
• Providers in Ocala, FL by specialty
• Home Health Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.