Kimberly Anne Moulliet, NURSE PRACTITIONER

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

700465 Issued in NV

Practice address

3835 S Jones Blvd Ste 104
Las Vegas, NV 89103-2283

Phone

(775) 570-9050

NPI assigned

Oct 21, 2008

Sex

Female

Sole proprietor

Yes

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 CA

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

Specialty

Nurse Practitioner

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Marshall Medical CenterGroup PAC ID 7517875859, 168 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Marshall Medical Center Hospital, Placerville, CA, CCN 050254

Medicare enrollment (NPD)

Enrolled

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.

• Marshall Medical Center

  • Family Medicine Physician
  • El Dorado Hills, CA
  • NPI 1114727377
  Medicare reassignment Care Compare group NPD
• Marshall Medical Center

  • Orthopaedic Surgery Physician
  • Placerville, CA
  • NPI 1649562315
  NPD
• Comprehensive Urgent Care

  • Urgent Care Clinic/Center
  • Las Vegas, NV
  • NPI 1578478673
  NPD (past)
• Marshall Medical Center

  • Interventional Cardiology Physician
  • Placerville, CA
  • NPI 1215181664
  NPD (past)

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

• Marshall Medical Center

  • General Acute Care Hospital
  • Placerville, CA
  • NPI 1972503142
  Care Compare affiliation

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

{
    "created_epoch": "1224547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349913600000",
    "number": "1902058977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3835 S JONES BLVD STE 104",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891032283",
            "telephone_number": "702-570-9050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3835 S JONES BLVD STE 104",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891032283",
            "telephone_number": "775-570-9050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOULLIET",
        "first_name": "KIMBERLY",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-21",
        "last_updated": "2012-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "700465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mouchir S Harb MD LTD
• Dyana Marie Moudarres
• Collin Mould
• Danielle Mould, FNP
• Leela Mouli
• Hanh Moulton
• Rachel Moulton
• Terry Moulton
• William B. Moulton, D.D.S.
• Morgan Futch Moumouris, NCC

• Family Nurse Practitioner in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Family Nurse Practitioner in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2012; 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.