Kelly King Moore, MS, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

R3638 Issued in KY

Practice address

330 Waller Ave Ste 275
Lexington, KY 40504-2930

Phone

(859) 447-8600

Fax

(859) 447-8599

NPI assigned

Aug 17, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Danville Orthopaedics & Sports Medicine, PSC

  • Orthopaedic Surgery Physician
  • Danville, KY
  • NPI 1477547073
  NPD (past)
• Kentucky Hand and Physical Therapy BC LLC

  • Physical Therapist
  • Lexington, KY
  • NPI 1639501224
  NPD (past)
• Professional Rehabilitation Associates, PSC

  • Physical Therapist
  • Richmond, KY
  • NPI 1669463170
  NPD (past)
• Drayer Physical Therapy Institute LLC

  • Physical Therapist
  • York, PA
  • NPI 1053348409

  Occupational Therapist

  NPD (past)

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614729600000",
    "number": "1619080272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 WALLER AVE STE 275",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405042930",
            "telephone_number": "859-447-8600",
            "fax_number": "859-447-8599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 WALLER AVE STE 275",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405042930",
            "telephone_number": "859-447-8600",
            "fax_number": "859-447-8599"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "212 Wayne Dr",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "KY",
            "postal_code": "404752337",
            "country_code": "US",
            "telephone_number": "859-625-0564 x27",
            "fax_number": "859-625-1109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "KELLY",
        "middle_name": "KING",
        "name_prefix": "Mrs.",
        "credential": "MS, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-17",
        "last_updated": "2021-03-03",
        "certification_date": "2021-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "KY",
            "license": "R3638",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100401980",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James C. Moore, LCSW
• James Daniel Moore, M.D.
• John Michael Moore, M.D.
• Kaitlyn Danielle Moore
• Karabeth Moore, MD
• Kelly N Moore, MSSW, LCSW
• Laura Moore, LPCC
• Lillian Mae Moore
• Melanie Moore
• Melinda Moore, PHD

• Occupational Therapist in Lexington, KY
• Providers in Lexington, KY by specialty
• Occupational Therapist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2021; 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.