Kelley C Moore, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

209 Issued in AK

Practice address

101 Bodin Cir
Travis Afb, CA 94535-1809

Phone

(937) 668-2438

NPI assigned

Sep 27, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH, FL2 enrollments

Enrollment records 2

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Anesthesia Services of Greater Dayton LLCGroup PAC ID 1658520747, 24 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

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.

• Anesthesia Services of Greater Dayton, LLC

  • Certified Registered Nurse Anesthetist
  • Beavercreek, OH
  • NPI 1407132830

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Anesthesia Dynamics LLC

  • Anesthesiology Physician
  • Bradenton, FL
  • NPI 1073001012

  Nurse Anesthetist, Certified Registered, OH

  Medicare reassignment NPD
• Gi Anesthesia, LLC

  • Anesthesiology Physician
  • Dayton, OH
  • NPI 1730332610
  Medicare reassignment NPD
• Ocala Endoscopy Anesthesia LLC

  • Certified Registered Nurse Anesthetist
  • Fort Myers, FL
  • NPI 1386693240

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• PHS Anesthesia Billing, LLC

  • Anesthesiology Physician
  • Middletown, OH
  • NPI 1578361044
  NPD
• Anesthesia Associates of Lima Inc

  • Certified Registered Nurse Anesthetist
  • Lima, OH
  • NPI 1487662300

  Nurse Anesthetist, Certified Registered

  NPD (past)
• Anesthesiology Consultants of Toledo, Inc

  • Anesthesiology Physician
  • Toledo, OH
  • NPI 1366482119
  NPD (past)
• Anesthesiology Services Network LTD

  • Anesthesiology Physician
  • Dayton, OH
  • NPI 1821076779
  NPD (past)
• Blair County Anesthesia, P.C.

  • Anesthesiology Physician
  • Altoona, PA
  • NPI 1003864612
  NPD (past)
• Lexington Anesthesia Associates, Inc.

  • Certified Registered Nurse Anesthetist
  • Altoona, PA
  • NPI 1932144029

  Nurse Anesthetist, Certified Registered

  NPD (past)
• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)
• Mercy Tyler Health Systems

  • Surgery Physician
  • Tunkhannock, PA
  • NPI 1881616985
  NPD (past)

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

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415145600000",
    "number": "1639165343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 BODIN CIR",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945351809",
            "telephone_number": "937-668-2438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BODIN CIR",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945351809",
            "telephone_number": "937-668-2438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "KELLEY",
        "middle_name": "C",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-27",
        "last_updated": "2014-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AK",
            "license": "209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward Francis Mitnitsky, DDS
• Royce Molick, D.O.
• Teresa Monteon
• Jorge Montequin, CRNA
• Fredrick Allen Moore Sr., LISW
• Kevin Lionel St Patrick Moore, IDMT
• Jodie Moraes, APRN
• Cody Ronald Morcom, PHARMD, BCPS
• Miguel Julian Moreno
• Ali Morrell-Balanon, M.D.

• Certified Registered Nurse Anesthetist in Travis Afb, CA
• Providers in Travis Afb, CA by specialty
• Certified Registered Nurse Anesthetist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.