HATTIE KELLY-MOODY (NPI# 1528213568) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528213568 |
| Entity Type | Individual |
| Full Name | HATTIE KELLY-MOODY |
| Credential | RN |
| Practice Address |
460 Main St Buffalo NY 14202-3203 |
| Practice Telephone | 7168550163 |
| Practice Fax Number | 7168552023 |
| Mailing Telephone | 7168550163 |
| Mailing Fax Number | 7168552023 |
| Enumeration Date | 2008-11-18 |
| Last Update Date | 2008-11-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WA0400X |
Registered Nurse Specialization: Addiction (Substance Use Disorder) |
00359841 | NY | Nursing Service Providers |
| Street Address |
460 MAIN ST |
| City | BUFFALO |
| State | NY |
| Zip Code | 14202-3203 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144475195 | Thomas Ireland | Social Worker | 460 Main St, Buffalo, NY 14202-3203 | 2008-11-18 |
| 1649425687 | Roy Lennon | Social Worker | 460 Main St, Buffalo, NY 14202-3203 | 2008-11-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376141655 | Deborah Elaine Ricci | Counselor | 43o Niagara Sq, Buffalo, NY 14202 | 2020-10-09 |
| 1831716208 | Meagan Licata | Counselor | Bestself Behavioral Health, 255 Delaware Ave Ste 300, Buffalo, NY 14202 | 2020-07-01 |
| 1962022483 | Autumn Marie Hayes I | Counselor | 625 Deleware Avenue, Suite 204, Buffalo, NY 14202 | 2020-04-24 |
| 1861012742 | Natasha Qutab | Student in an Organized Health Care Education/Training Program | Department of Neurology, 1010 Main Street, 2nd Floor, Buffalo, NY 14202 | 2020-04-21 |
| 1396232245 | Wood Dental LLC | Dentist | 564 Franklin Street, Buffalo, NY 14202 | 2018-04-17 |
| 1083130728 | Lydia Heeeun Doublestein | Advanced Practice Midwife | 367 Delaware Ave, Buffalo, NY 14202 | 2017-08-15 |
| 1356861652 | Michelle Cheesman | Speech-Language Pathologist | 801 City Hall, Buffalo, NY 14202 | 2017-06-27 |
| 1275082075 | Tempresst Nycole Batts Ravenell | Registered Nurse | 69 Delaware Ave Suite 1200, Interim Healthcare, Buffalo, NY 14202 | 2016-09-22 |
| 1972974764 | Tiffany Tyran | Registered Nurse | 69 Delaware Ave, Suite 1200, Buffalo, NY 14202 | 2015-10-19 |
| 1487044368 | Katherine Jeffries-coppola | Registered Nurse | 69 Delaware Ave. Suite 1200, Buffalo, NY 14202 | 2015-01-29 |
| Find all providers in zip 14202 | ||||
| Taxonomy Code | 163WA0400X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093244600 | Megan Heineman | Registered Nurse | 3020 Bailey Ave, Buffalo, NY 14215 | 2017-06-07 |
| 1144606187 | Deborah Morrison | Registered Nurse | 254 Virginia St, Buffalo, NY 14201-1938 | 2015-07-31 |
| 1467863340 | Rayne Thoman | Registered Nurse | 951 Niagara St, Buffalo, NY 14213-2116 | 2014-05-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013528363 | Ophelia Medical Group Ny, P.C. | Registered Nurse | 755 Park Ave Apt 4a, New York, NY 10021-4282 | 2020-08-11 |
| 1982220919 | Christine Marie Fitzsimmons | Registered Nurse | 104-106 E 126th Street, 1a, New York, NY 10035 | 2020-06-25 |
| 1811533151 | Kay Lobo Cordes | Registered Nurse | 6501 E Inducon Drive, Sanborn, NY 14132 | 2019-11-21 |
| 1396393633 | Emmanuelle Sheridan | Registered Nurse | 102 Fountain Ave, Selden, NY 11784-1908 | 2019-08-29 |
| 1750846267 | Shaedele Renise Desamours | Registered Nurse | 1825 Park Ave Fl 8, New York, NY 10035-1641 | 2019-02-08 |
| 1417459546 | Kristie Matos | Registered Nurse | 2778 3rd Ave, Bronx, NY 10455-4029 | 2018-03-05 |
| 1982116166 | Angela Douglas | Registered Nurse | 1001 E 55th St, Brooklyn, NY 11234-1701 | 2017-10-28 |
| 1669994497 | Sheila Lenora Eastmond-chapman | Registered Nurse | 547 Pine St, Brooklyn, NY 11208-3901 | 2017-07-13 |
| 1184160814 | Christopher Cox | Registered Nurse | 46 5th Ave S, Huntington Station, NY 11746-2343 | 2017-01-19 |
| 1518401629 | Fawn Erin Medina | Registered Nurse | 2920 Wilson Avenue, Bronx, NY 10469 | 2016-12-08 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.