Kamesha Dees Moultry, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1-101408 Issued in AL

Practice address

1970 Andrews Ave
Ozark, AL 36360-3726

Phone

(334) 774-1555

NPI assigned

Sep 6, 2016

Last updated

Jul 23, 2021By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in AL

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

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

East Central Mental Health Mental Retardation, Inc.Group PAC ID 3870575202, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Troy Regional Medical Center Hospital, Troy, AL, CCN 010126

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• East Central Mental Health Mental Retardation, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Troy, AL
  • NPI 1285717413
  Medicare reassignment Care Compare group NPD
• Southern NP Associates, LLC

  • Adult Health Nurse Practitioner
  • Tuscaloosa, AL
  • NPI 1407257447
  Medicare reassignment NPD
• Emedical Group Inc

  dba ePediatrics and Family Care

  • Rural Health Clinic/Center
  • Union Springs, AL
  • NPI 1912203712
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Troy Hospital Health Care Authority

  dba Troy Regional Medical Center

  • Rural Acute Care Hospital
  • Troy, AL
  • NPI 1770814626
  Care Compare affiliation

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

{
    "created_epoch": "1473120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626998400000",
    "number": "1649727850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2812 HARTFORD HWY STE 1",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363054927",
            "telephone_number": "334-712-1170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1970 ANDREWS AVE",
            "city": "OZARK",
            "state": "AL",
            "postal_code": "363603726",
            "telephone_number": "334-774-1555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2812 Hartford Hwy Ste 1",
            "address_purpose": "LOCATION",
            "city": "Dothan",
            "state": "AL",
            "postal_code": "363054927",
            "country_code": "US",
            "telephone_number": "334-712-1170",
            "fax_number": "334-460-8391",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOULTRY",
        "first_name": "KAMESHA",
        "middle_name": "DEES",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-06",
        "last_updated": "2021-07-23",
        "certification_date": "2021-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-101408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Moody, PHARM.D
• Tessa Moody
• Melissa Catherine Moore, MASSAGE THERAPIST
• John Morrow, ALC
• Katie Moul, MSOTR/L
• James Russell Murphree Jr., DMD
• Amber Danielle Murray, PA-C
• Julie Ann Murray
• Melanie Myrick, ALC
• Newgen Alabama Billing LLC

• Family Nurse Practitioner in Ozark, AL
• Providers in Ozark, AL by specialty
• Family Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.