Kelley K. Moore, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

32806 Issued in CO

Practice address

4851 Independence St.
70 Executive Center
Wheat Ridge, CO 80033-6715

Phone

(303) 432-5101

Fax

(303) 432-5071

NPI assigned

Jan 30, 2007

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 CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Jefferson Center for Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Wheat Ridge, CO
  • NPI 1154403798
  Medicare reassignment
• Jefferson Center for Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Evergreen, CO
  • NPI 1639350879
  NPD (past)

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229990400000",
    "number": "1740326289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4851 INDEPENDENCE ST.",
            "address_2": "70 EXECUTIVE CENTER",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "80033",
            "telephone_number": "303-432-5101",
            "fax_number": "303-432-5071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4851 INDEPENDENCE ST.",
            "address_2": "70 EXECUTIVE CENTER",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800336715",
            "telephone_number": "303-432-5101",
            "fax_number": "303-432-5071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "KELLEY",
        "middle_name": "K.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2008-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CO",
            "license": "32806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Distefano Monteleone
• Jamie Montoya
• Nancy Dinora Monzon
• Hannah Ruth Mooi, NONE
• Katherine M Moore
• Valerie Morgan Moore, PHARMD
• April Morago
• Nathan John Morago, CSFA
• Haley Moran, PT, DPT
• Shela Morben

• Child & Adolescent Psychiatry Physician in Wheat Ridge, CO
• Providers in Wheat Ridge, CO by specialty
• Child & Adolescent Psychiatry Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.