KALI JO MOE (NPI# 1790238160) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790238160 |
| Entity Type | Individual |
| Full Name | KALI JO MOE |
| Credential | FNP-C |
| Practice Address |
510 Lincoln Dr Herrin IL 62948-6334 |
| Practice Telephone | 6189976800 |
| Practice Fax Number | 6189989385 |
| Mailing Telephone | 6189976800 |
| Mailing Fax Number | 6189989385 |
| Enumeration Date | 2016-08-02 |
| Last Update Date | 2020-10-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
340962 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 04546549 | 05 |
| Street Address |
510 LINCOLN DR |
| City | HERRIN |
| State | IL |
| Zip Code | 62948-6334 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023001377 | Southern Illinois Orthopedic Center,llc | Clinic/Center | 510 Lincoln Dr, Herrin, IL 62948-6334 | 2005-08-23 |
| 1629682471 | Rachel Peterson | Physical Therapist | 510 Lincoln Dr, Herrin, IL 62948-6334 | 2020-08-31 |
| 1679119572 | Marcia Skinner | Physical Therapy Assistant | 510 Lincoln Dr, Herrin, IL 62948-6334 | 2019-11-26 |
| 1790321602 | Braden Reeves | Physical Therapy Assistant | 510 Lincoln Dr, Herrin, IL 62948-6334 | 2019-11-26 |
| 1508402652 | Joshua Sheldon | Physical Therapy Assistant | 510 Lincoln Dr, Herrin, IL 62948-6334 | 2019-11-25 |
| 1801432968 | Sydney Allen | Physical Therapy Assistant | 510 Lincoln Dr, Herrin, IL 62948-6334 | 2019-11-25 |
| 1487290532 | Michelle Reed | Occupational Therapy Assistant | 510 Lincoln Dr, Herrin, IL 62948-6334 | 2019-11-25 |
| 1689235715 | Michelle Steh | Nurse Practitioner | 510 Lincoln Dr, Herrin, IL 62948-6334 | 2019-06-28 |
| 1427576180 | Amelie H Wilson | Physical Therapist | 510 Lincoln Dr, Herrin, IL 62948-6334 | 2017-09-01 |
| 1336555051 | Shannon Waldon | Specialist/Technologist, Other | 510 Lincoln Dr, Herrin, IL 62948-6334 | 2014-07-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215307590 | Carmelito Miralles Caronongan | Pediatrics | 120 S. 11th St., Herrin, IL 62948 | 2015-09-30 |
| 1073995684 | Motaz R Wraikat | Preventive Medicine | 315 S 13th St Ste 3, Herrin, IL 62948 | 2015-06-19 |
| 1639427933 | Salim Hosein | Surgery | 317 S 14th St Ste 1, Herrin, IL 62948 | 2012-08-17 |
| 1962780288 | Pooja Sareen | Internal Medicine | 3024 S Park Avenue, Herrin, IL 62948 | 2011-08-03 |
| 1235459918 | Timoteo Castro Md & Josefina D. Castro Md Ltd | Family Medicine | 321 South 13st St., Herrin, IL 62948 | 2010-06-04 |
| 1457501926 | Don Cassidy Arnold II | Urology | 220 S Park Ave Fl 2, Herrin, IL 62948 | 2008-09-22 |
| 1306094560 | Karl Keith Mitchener | Speech-Language Pathologist | 1901 N 13th Street, Herrin, IL 62948 | 2008-08-29 |
| 1457509705 | Kathryn Marie Bordenet-jines | Occupational Therapy Assistant | 1901 N. 13th, Herrin, IL 62948 | 2008-08-28 |
| 1417105776 | Cheryl Lynn Matic | Occupational Therapy Assistant | 1901 N. 13th St., Herrin, IL 62948 | 2008-08-28 |
| 1174771422 | Mary Frances Graham | Physical Therapy Assistant | 1901 N. 13th Street, Herrin, IL 62948 | 2008-08-28 |
| Find all providers in zip 62948 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508476615 | Adam Waller | Nurse Practitioner | 408 Lincoln Dr Ste B, Herrin, IL 62948-3790 | 2020-08-04 |
| 1942854526 | Janelle Renee Kirby | Nurse Practitioner | 201 S 14th St, Herrin, IL 62948-3631 | 2019-07-31 |
| 1538722202 | Kathy Sue Devous | Nurse Practitioner | 405 Rushing Dr, Herrin, IL 62948-3730 | 2019-04-18 |
| 1427511757 | Rachel Marie Bailey | Nurse Practitioner | 3305 Logan Dr, Herrin, IL 62948-3732 | 2019-04-12 |
| 1003334459 | Whitney Mcguire | Nurse Practitioner | 405 Rushing Dr, Herrin, IL 62948-3730 | 2017-09-06 |
| 1952835910 | Devin Renee Haub | Nurse Practitioner | 201 S 14th St, Herrin, IL 62948-3631 | 2017-04-17 |
| 1417305293 | Danielle Baker | Nurse Practitioner | 3224 S Park Ave, Herrin, IL 62948-3715 | 2016-06-02 |
| 1538406038 | Lori Lee Ellett | Nurse Practitioner | 3314 Patriot Ct, Herrin, IL 62948 | 2013-01-03 |
| 1295017663 | Deanna L. Tacderas | Nurse Practitioner | 317 S 14th St, Herrin, IL 62948-3671 | 2011-09-12 |
| 1750526810 | Shanda Conrad Swagler | Nurse Practitioner | 220 N Park Ave, Herrin, IL 62948-3150 | 2008-12-03 |
| Find all providers in HERRIN | ||||
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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.