MS. KELLEY C MOORE (NPI# 1639165343) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639165343 |
| Entity Type | Individual |
| Full Name | MS. KELLEY C MOORE |
| Credential | CRNA |
| Practice Address |
101 Bodin Cir Travis Afb CA 94535-1809 |
| Practice Telephone | 9376682438 |
| Mailing Telephone | 9376682438 |
| Enumeration Date | 2005-09-27 |
| Last Update Date | 2014-11-05 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | 209 | AK | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598958647 | Kelley Newman Moore | Dentist | 1 Orange Ave, Rockledge, FL 32955-2945 | 2007-08-22 |
| 1740326289 | Kelley K. Moore | Psychiatry & Neurology | 4851 Independence St., 70 Executive Center, Wheat Ridge, CO 80033-6715 | 2007-01-30 |
| 1871084335 | Kelley Moore | Counselor | 3000 Bethesda Pl Ste 202, Winston Salem, NC 27103-3324 | 2018-05-21 |
| 1417313784 | Kelley Nicole Moore | Pharmacist | 3745 Louisiana Ave S, St Louis Park, MN 55426-4361 | 2016-01-02 |
| 1679823538 | Kelley Michelle Moore | Case Manager/Care Coordinator | 1911 Williams Dr, Oxnard, CA 93036-2612 | 2012-09-18 |
| 1205026531 | Kelley Rene Moore | Case Manager/Care Coordinator | 4425 Jefferson Ave, Suite 106, Texarkana, AR 71854-1535 | 2007-08-01 |
| Street Address |
101 BODIN CIR |
| City | TRAVIS AFB |
| State | CA |
| Zip Code | 94535-1809 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801893276 | Charles A Tujo | Radiology | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2005-06-30 |
| 1538769351 | Chelsey Violet Pelkey | Military Health Care Provider | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2020-10-30 |
| 1538768114 | Jordan Rose | Student in an Organized Health Care Education/Training Program | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2020-10-23 |
| 1821606591 | Madelyn Hale | Military Health Care Provider | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2020-07-20 |
| 1932727856 | Julie Thein | Audiologist | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2020-07-07 |
| 1063039501 | Shae Daniel Bryant | Dentist | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2020-07-01 |
| 1598381089 | Aaron J Surbaugh | Student in an Organized Health Care Education/Training Program | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2020-06-19 |
| 1194348466 | Amanda Vance | Registered Nurse | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2020-05-21 |
| 1427681196 | Bradley Burkey | Student in an Organized Health Care Education/Training Program | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2020-02-20 |
| 1821629288 | Gloria Calvillo | Student in an Organized Health Care Education/Training Program | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2020-02-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508487711 | Sheila C Flood | Student in an Organized Health Care Education/Training Program | 101 Biden Circle, Fairfield, CA 94535 | 2020-04-28 |
| 1568081255 | Miguel Julian Moreno | Student in an Organized Health Care Education/Training Program | 690 Airmen Drive, Travis Afb, CA 94535 | 2020-04-13 |
| 1174096101 | Zlatoslava Karga | Nurse Practitioner | 60mdg / Sgow, 101 Bodin Circle, Travis Afb, CA 94535 | 2019-01-02 |
| 1437648292 | Luke C Vera | Dentist | David Grant Medical Center 101 Bodin Circle, Travis Air Force Base, CA 94535 | 2018-05-08 |
| 1588163430 | Sanaz Ziad | Pharmacist | 60mdg/mdts, 101 Bodin Circle, Travis Afb, CA 94535 | 2018-02-06 |
| 1194265686 | Geoffrey Johnston | Dentist | 60 Mdg/sgdd, 101 Bodin Circle, Travis Afb, CA 94535 | 2017-03-02 |
| 1336693407 | Hannah Isla Nordwall | Social Worker | 60 Mdg/mdos 101 Bodin Cir, Travis Afb, CA 94535 | 2016-08-06 |
| 1184177149 | Taylor Murrie-robinson | Social Worker | 60mdg / Sgow Mental Health Clinic, 101 Bodin Circle, Travis Afb, CA 94535 | 2016-07-26 |
| 1952759607 | Eric Kincaid-sharp | General Practice | 60 Mdg/amds, 101 Bodin Cir, Travis Afb, CA 94535 | 2016-06-02 |
| 1023472040 | Genieve Marie Martinez-hernandez | Internal Medicine | 60 Mdg/sgomi, 101 Bodin Circle, Fairfield, CA 94535 | 2016-04-06 |
| Find all providers in zip 94535 | ||||
| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548645534 | Robert Shaun Revels | Nurse Anesthetist, Certified Registered | 624 Norton St, Travis Afb, CA 94535-1356 | 2015-07-20 |
| 1457495640 | Jade K Barrow | Nurse Anesthetist, Certified Registered | 60 Mdg/sgcj, 101 Bodin Circle, Travis Afb, CA 94535 | 2007-02-19 |
| 1992358105 | Whitney Dorame | Nurse Anesthetist, Certified Registered | 60 Mdg/sgcj, 101 Bodin Cir, Travis Afb, CA 94535-1800 | 2019-07-17 |
| 1932760006 | Katherine L Knott | Nurse Anesthetist, Certified Registered | 101 Bodin Circle, Travis Afb, CA 94535-1800 | 2019-06-27 |
| 1811406499 | Jessica Newcomb | Nurse Anesthetist, Certified Registered | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2017-09-26 |
| 1225567191 | Laura Jane Ransom | Nurse Anesthetist, Certified Registered | 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2017-06-05 |
| 1336683747 | David J Krasucki | Nurse Anesthetist, Certified Registered | David Grant Medical Center, 101 Bodin Cir, Travis Afb, CA 94535 | 2016-12-05 |
| 1891242483 | Emily Roark | Nurse Anesthetist, Certified Registered | 101 Bodin Circle, 60 Mdg/sgcj, Travis Afb, CA 94535-1809 | 2016-09-01 |
| 1871948208 | Jennifer Fielding | Nurse Anesthetist, Certified Registered | 60 Mdg, 101 Bodin Cir, Travis Afb, CA 94535 | 2016-05-04 |
| 1649692328 | Julie Petsche | Nurse Anesthetist, Certified Registered | 101 Bodin Cir, Travis Afb, CA 94535 | 2014-01-14 |
| Find all providers in TRAVIS AFB | ||||
| City | TRAVIS AFB |
| Zip Code | 94535 |
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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.