KELLY M. MOSS (NPI# 1841640455) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1841640455 |
Entity Type | Individual |
Full Name | KELLY M. MOSS |
Credential | NP |
Practice Address |
700 Sullivan Rd Statesville NC 28677-3440 |
Mailing Address |
Po Box 1845 Statesville NC 28687-1845 |
Practice Telephone | 7049249111 |
Practice Fax Number | 7048830452 |
Enumeration Date | 2016-06-14 |
Last Update Date | 2020-06-18 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
5009456 | NC | Physician Assistants & Advanced Practice Nursing Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1649646712 | Kelly Moss | Counselor | 102 Aberdeen Dr, Sicklerville, NJ 08081-4338 | 2015-08-12 |
1396374476 | Kelly Moss | Behavior Technician | 514 S Hunt Club Blvd, Apopka, FL 32703-4948 | 2020-04-02 |
1225512478 | Kelly Nicole Moss | Physician Assistant | 601 Spruce St, West Reading, PA 19611-1443 | 2018-09-23 |
1407023740 | Kelly Paige Moss | Psychologist | 1650 Cochrane Circle, Evans Army Comm Hosp Behavioral Health 4th Floor, Apo, AA 80913-4604 | 2008-05-15 |
1114936192 | Kelly G Moss | Family Medicine | 211 Ky 59, Vanceburg, KY 41179-7647 | 2006-08-07 |
Street Address |
700 SULLIVAN RD |
City | STATESVILLE |
State | NC |
Zip Code | 28677-3440 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1881661205 | Burgo Doyle Gill IIi | Physician Assistant | 700 Sullivan Rd, Statesville, NC 28677-3440 | 2006-03-03 |
1194379123 | Wesley Lockman | Registered Nurse | 700 Sullivan Rd, Statesville, NC 28677-3440 | 2019-07-29 |
1780130518 | Jason Noble | Physician Assistant | 700 Sullivan Rd, Statesville, NC 28677-3440 | 2016-08-31 |
1811291636 | Carol Lynn La Torre | Nurse Practitioner | 700 Sullivan Rd, Statesville, NC 28677-3440 | 2011-01-08 |
1306035373 | Paul Anthony Leonard | Physician Assistant | 700 Sullivan Rd, Statesville, NC 28677-3440 | 2007-10-16 |
1073677720 | Cynthia Loree Mitchell | Physician Assistant | 700 Sullivan Rd, Statesville, NC 28677-3440 | 2006-12-20 |
1255388930 | Susan M Quirk | Physician Assistant | 700 Sullivan Rd, Statesville, NC 28677-3440 | 2006-05-28 |
1558324152 | Kelly Ann Boone | Nurse Practitioner | 700 Sullivan Rd, Statesville, NC 28677-3440 | 2006-04-07 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1306472311 | Crystal Medley Hopkins | Nurse Practitioner | 105 Summer Breeze Court, Statesville, NC 28677 | 2020-03-21 |
1922634484 | Tracey Holton | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Easterseals Ucp, 913 Carolina Ave N, Statesville, NC 28677 | 2020-03-17 |
1962069286 | Leap Child & Family Services LLC | Developmental Therapist | 119 North Tradd Street, Statesville, NC 28677 | 2019-05-22 |
1831604891 | Ingles Markets Inc | Pharmacy | 722 Sullivan Rd, Statesville, NC 28677 | 2017-12-12 |
1235663162 | Sandra Lorraine Scalese | Physical Therapy Assistant | 520 Valley Street, Brian Center Health and Rehabilitation, Statesville, NC 28677 | 2017-04-18 |
1437698891 | Sherry Blevins Hager | Pharmacist | 722 Sullivan Road, Statesville, NC 28677 | 2017-02-17 |
1063828507 | Susan Marie S Sheffield | Dentist | 518 Brookdale Drive, Statesville, NC 28677 | 2014-07-04 |
1659782449 | Easter Seals Ucp | Community/Behavioral Health | 913 Carolina Ave, Statesville, NC 28677 | 2014-05-14 |
1306268016 | Randall Scott Perry | Dentist | 1132 Davie Avenue, Statesville, NC 28677 | 2014-01-15 |
1215215876 | Silhouette Enterprises | Prosthetic/Orthotic Supplier | 909 Carolina Ave, Statesville, NC 28677 | 2011-08-01 |
Find all providers in zip 28677 |
Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1548887706 | Tasha Marie Vangile | Nurse Practitioner | 120 Westview Ln, Statesville, NC 28625-8221 | 2020-07-02 |
1306472311 | Crystal Medley Hopkins | Nurse Practitioner | 105 Summer Breeze Court, Statesville, NC 28677 | 2020-03-21 |
1144626003 | Valorie Stewart Byrd | Nurse Practitioner | 150 Magnolia Hill Ln, Statesville, NC 28677-9735 | 2014-11-05 |
1538461967 | Bethany J Sprague | Nurse Practitioner | 2632 Fines Creek Dr, Statesville, NC 28625 | 2010-11-17 |
1427362367 | Melissa Stevens Jolly | Nurse Practitioner | 513 Brookdale Dr, Statesville, NC 28677-4107 | 2010-08-03 |
1558695213 | Jessica Daniels Wood | Nurse Practitioner | 310 Davie Avenue, Statesville, NC 28677 | 2009-09-29 |
1477789147 | Greenbriar Primary Care, Pa | Nurse Practitioner | 308-c Mocksville Highway, Statesville, NC 28625 | 2009-06-08 |
1508063355 | Ann Green Moose | Nurse Practitioner | 1893 E Broad St # B-4, Statesville, NC 28625-4307 | 2007-06-27 |
1073739843 | Judy Lackey Keighron | Nurse Practitioner | 308c Mocksville Hwy, Statesville, NC 28625-8267 | 2007-04-18 |
1578788741 | Beverly B Sproul | Nurse Practitioner | 470 Crawford Rd, Statesville, NC 28625-8545 | 2007-04-14 |
Find all providers in STATESVILLE |
City | STATESVILLE |
Zip Code | 28677 |
Please comment or provide details below to improve the information on KELLY M. MOSS.
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.