Active NPI
Kathryn Renee Moseley, PA-C
- Physician Assistant
- Martinsburg, WV
National Provider Identifier
1740586429
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0110003519
- Practice address
- 510 Butler Ave BLDG 413B
Martinsburg, WV 25405-9990 - Phone
- (304) 263-0811
- NPI assigned
- Jan 28, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0110003519 | VA | Primary |
Addresses
Primary practice location
510 Butler Ave BLDG 413B
Martinsburg, WV 25405-9990
Mailing address
6801 Middle Rd
Middletown, VA 22645-2114
Phone (540) 931-6707
Other practice location 1
2281 Valley Ave
Winchester, VA 22601-2755
Phone (540) 278-2228
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740586429 | Medicaid | VA |
Other names 1
- Kathryn Renee Durbin
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230613001898 | VA | Order and Referring Only - Physician Assistant | 2567648793 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Privia Medical Group, LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Internal Medicine Physician
- Arlington, VA
- NPI 1013042480
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1296172800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1703808000000",
"number": "1740586429",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6801 MIDDLE RD",
"city": "MIDDLETOWN",
"state": "VA",
"postal_code": "226452114",
"telephone_number": "540-931-6707"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "510 BUTLER AVE BLDG 413B",
"city": "MARTINSBURG",
"state": "WV",
"postal_code": "254059990",
"telephone_number": "304-263-0811"
}
],
"practiceLocations": [
{
"address_1": "2281 Valley Ave",
"address_purpose": "LOCATION",
"city": "Winchester",
"state": "VA",
"postal_code": "226012755",
"country_code": "US",
"telephone_number": "540-278-2228",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MOSELEY",
"first_name": "KATHRYN",
"middle_name": "RENEE",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-01-28",
"last_updated": "2023-12-29",
"certification_date": "2023-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "VA",
"license": "0110003519",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1740586429",
"state": "VA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "KATHRYN",
"last_name": "DURBIN",
"middle_name": "RENEE",
"credential": "PA-C",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Martinsburg, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2023; 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.