Kelly Renee Moore, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

2016029955 Issued in MO

Practice address

130 Andor LN
Hillsboro, MO 63050-4606

Phone

(314) 520-1227

NPI assigned

Dec 7, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO, IA2 enrollments

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 2

Merit-based Incentive Payment System (MIPS)

Final score

93.67 of 100Reported as group

Quality

78.43

Improvement activities

40

Cost

74.32

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Barnes Health Care Management Group LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Columbia, MO
  • NPI 1396999686
  Medicare reassignment NPD
• Telemedico Physicians of Missouri

  • Cardiovascular Disease Physician
  • Jefferson City, MO
  • NPI 1700365707
  Medicare reassignment NPD
• Carelon Medical Partners, PC

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Nashville, TN
  • NPI 1124443403

  IA, MO

  Medicare reassignment

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

{
    "created_epoch": "1481068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667779200000",
    "number": "1780128942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 MARGARET MICHELLE CT",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633764812",
            "telephone_number": "314-520-1227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 ANDOR LN",
            "city": "HILLSBORO",
            "state": "MO",
            "postal_code": "630504606",
            "telephone_number": "314-520-1227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "KELLY",
        "middle_name": "RENEE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-07",
        "last_updated": "2022-11-07",
        "certification_date": "2022-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IL",
            "license": "209.015105",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MO",
            "license": "2016029955",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IL",
            "license": "209.015105",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "2016029955",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "1780128942",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bailey Jensen McKain, LMSW
• Fredric Leroy Melton, M.D.
• Maranda C Melton
• Ann Marie Mestres, LMSW
• Brittany Micco
• Heather Lynn Morgan, DO
• Rebecca Mueller
• Samantha Mueller
• Jessica Mungle, RDH
• Edward Jeffery Myles, D.O.

• Adult Health Nurse Practitioner in Hillsboro, MO
• Providers in Hillsboro, MO by specialty
• Adult Health Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2022; 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.