Individual provider Active NPI

Kendall Kirby Mora, ARNP

  • Family Nurse Practitioner
  • Vero Beach, FL
National Provider Identifier
1730448069
Registry record updated May 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9249484 Issued in FL
Practice address
1055 37TH PL
Vero Beach, FL 32960-6551
Phone
(772) 257-8700
NPI assigned
May 7, 2012
Last updated
May 7, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 9249484 FL Primary

Addresses

Primary practice location

1055 37TH PL
Vero Beach, FL 32960-6551

Mailing address

1770 Pointe West Way
Vero Beach, FL 32966-2444
Phone (772) 569-2708

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20121127000117 FL Practitioner - Nurse Practitioner 9436300365 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians
Lifeforce Healthcare, LLCGroup PAC ID 5092865568, 17 clinicians

Practice addresses (Care Compare)

1550 Killingsworth Way
The Villages, FL 32162-2175
Phone (352) 633-2971

1651 SW 42ND St
Ocala, FL 34471-1364
Phone (352) 873-3800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9249484FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lifeforce Healthcare LLC Family CurrentSince Apr 1, 2014 Accepting new patients
New Vision Surgical Center, LLC Past Accepting new patients
New Vision Eye Center, LLC PastSince Jul 20, 2009 Accepting new patients
Florida Health Care LLC Past Accepting new patients

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1336348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336348800000",
    "number": "1730448069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1770 POINTE WEST WAY",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329662444",
            "telephone_number": "772-569-2708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 37TH PL",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329606551",
            "telephone_number": "772-257-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORA",
        "first_name": "KENDALL",
        "middle_name": "KIRBY",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-07",
        "last_updated": "2012-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9249484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

Verify at the official NPI Registry.