Individual provider Active NPI

Moya P Butler, RN, NP

  • Family Nurse Practitioner
  • Kennesaw, GA
National Provider Identifier
1912263799
Registry record updated Mar 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN200355 Issued in GA
Practice address
2782 N Cobb Pkwy
Kennesaw, GA 30152-3472
Phone
(866) 389-2727
NPI assigned
Apr 6, 2012
Last updated
Mar 4, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2026

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 355623 NY
Family Nurse Practitioner 363LF0000X 26NJ15487900 NJ
Family Nurse Practitioner 363LF0000X SP032953 PA
Registered Nurse 163W00000X RN300255 GA
Family Nurse Practitioner 363LF0000X RN200355 GA Primary
Registered Nurse 163W00000X 593137 GA

Addresses

Primary practice location

2782 N Cobb Pkwy
Kennesaw, GA 30152-3472

Mailing address

2059 Scenic Hwy N Ste 103B
Snellville, GA 30078-6141
Phone (866) 551-9700

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Mbutler0602@aol.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, PA, NY, NJ4 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 4

Enrollment IDStateProvider typePAC IDDetails
I20241126000325 GA Practitioner - Nurse Practitioner 2466987698 Reassigns benefits to 3 organizations
I20250616000011 PA Practitioner - Nurse Practitioner 2466987698 Reassigns benefits to 1 organization
I20250618003122 NY Practitioner - Nurse Practitioner 2466987698 Reassigns benefits to 3 organizations
I20260414003934 NJ Practitioner - Nurse Practitioner 2466987698 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ophelia Medical Group FL PAGroup PAC ID 7810398534, 103 clinicians

Practice addresses (Care Compare)

161 Cecil B Moore Ave
Apt 204
Philadelphia, PA 19122-3243
Phone (215) 585-2144

527 Bay Rd
Suite 7
Queensbury, NY 12804-1430
Phone (215) 585-2144

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
593137GAMDRegistered Nurse
RN300255GAMDRegistered Nurse
26NJ15487900NJMDFamily Nurse Practitioner
SP032953PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ophelia Medical Group, P.C. CurrentSince Jun 9, 2025 Accepting new patients
Peachtree Immediate Care FP, LLC CurrentSince Oct 4, 2024 Accepting new patients
Wig Fix LLC CurrentSince Apr 10, 2022 Accepting new patients
Ophelia Medical Group FL, P.a. CurrentSince Jun 9, 2025 Accepting new patients
Community Care Health Network LLC CurrentSince Sep 1, 2025 Accepting new patients
Matrix Medical of New York PC CurrentSince Sep 1, 2025 Accepting new patients
Journey 2 Wellness Family Current Accepting new patients

Locations

9201 E Mountain View Rd
Ste 220
Scottsdale, AZ 85258
Phone (480) 862-1883

1000 Parkwood Cir SE
Ste 900
Atlanta, GA 30339
Phone (216) 393-8684

590 Lanier Ave W
Fayetteville, GA 30214

3827 Jimmy Lee Smith Pkwy
Hiram, GA 30141
Phone (770) 222-8900

2059 Scenic Hwy N
Ste 103B
Snellville, GA 30078
Phone (347) 248-9323

3991 Stone Mountain Hwy
Snellville, GA 30039
Phone (470) 482-6933

1740 Broadway
Fl 15
New York, NY 10019
Phone (201) 256-5032

18 E 41st St
Fl 14
New York, NY 10017
Phone (305) 395-4313

18 E 48th St
Fl 14
New York, NY 10017

228 Park Ave S
New York, NY 10003
Phone (215) 588-2144

527 Bay Rd
Ste 7
Queensbury, NY 12804
Phone (212) 585-2144

424 Church St
Ste 2600
Nashville, TN 37219
Phone (480) 450-3721

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1333670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772582400000",
    "number": "1912263799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2059 SCENIC HWY N STE 103B",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300786141",
            "telephone_number": "866-551-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2782 N COBB PKWY",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301523472",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "MOYA",
        "middle_name": "P",
        "credential": "RN, NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-06",
        "last_updated": "2026-03-04",
        "certification_date": "2026-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "355623",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ15487900",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP032953",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN300255",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN200355",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "593137",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Mbutler0602@aol.com",
            "affiliation": "N",
            "address_1": "116 W 32nd St",
            "address_2": "8th floor",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100013212",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kennesaw, GA

Sources for this page

Verify at the official NPI Registry.