Kelly Moody, RN

Primary specialty

School Registered NurseTaxonomy code 163WS0200X

License

L1-0029187 Issued in DE

Practice address

1235 Cedar Lane Rd
Middletown, DE 19709-9636

Phone

(302) 449-3499

NPI assigned

Aug 23, 2022

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 names 1

• Kelly S Shively Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1661212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661212800000",
    "number": "1730808759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1235 CEDAR LANE RD",
            "city": "MIDDLETOWN",
            "state": "DE",
            "postal_code": "197099636",
            "telephone_number": "302-449-3499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 CEDAR LANE RD",
            "city": "MIDDLETOWN",
            "state": "DE",
            "postal_code": "197099636",
            "telephone_number": "302-449-3499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOODY",
        "first_name": "KELLY",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-23",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "DE",
            "license": "L1-0029187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "SHIVELY",
            "middle_name": "S",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• School Registered Nurse in Middletown, DE
• Providers in Middletown, DE by specialty
• School Registered Nurse in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 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.