KHAMPHOU MANIVANH MOSLEY FNP-BC
NPI 1093205049
Nurse Practitioner - Family in Okeechobee, FL

Q: What is Khamphou Mosley's NPI number?

The NPI number for Khamphou Mosley is 1093205049. It was assigned to this individual provider in the NPPES registry on May 15, 2018.

Q: What is Khamphou Mosley's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Khamphou Mosley was last updated on June 25, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since May 15, 2018PECOS EnrolledAccepts Medicare Assignment

1100 N PARROTT AVE, OKEECHOBEE, FL 34972(863) 763-7481(844) 542-4899 Get Directions Write a Review

NPPES record last updated: June 25, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 25, 2024, Aug 2, 2018, Jul 23, 2018 and 1 more (4 updates tracked since 2018).

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About Khamphou Manivanh Mosley Fnp-bc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KHAMPHOU MANIVANH MOSLEY FNP-BC (NPI 1093205049) is an individual family provider in Okeechobee, Florida, licensed in Florida (APRN11002153) and active in the NPI registry since May 2018. She is enrolled in Medicare PECOS, is affiliated with Shorepoint Health Port Charlotte, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1093205049

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameKHAMPHOU MANIVANH MOSLEYCredential: FNP-BC

Location Address1100 N PARROTT AVEOkeechobee, FL 34972-2129

Mailing Address5827 Corporate WayWest Palm Beach, FL 33407-2000 · (561) 844-9443 · Fax (561) 472-9692

Phone(863) 763-7481

Fax(844) 542-4899

Sole ProprietorNo

Medical School CMSOtherGraduated 2017

Enumeration DateMay 15, 2018

Last NPPES UpdateJune 25, 20244 updates tracked since enumeration

NPPES CertifiedJune 25, 2024

✔ NPI 1093205049 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in FL · APRN11002153

Also ListedNurse PractitionerTaxonomy 363L00000X · License 21726 (SC), 5010768 (NC)

1100 N PARROTT AVE, Okeechobee, FL 34972

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Secondary Practice Locations 2

Location 12636 Elm Hill PikeNashville, TN 37214-3162 · Phone (347) 761-3230

Location 210130 Perimeter Pkwy Ste 200Charlotte, NC 28216-0197 · Phone (888) 849-7379 · Fax (855) 857-7333

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Superior HealthPlan, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Khamphou Manivanh Mosley Fnp-bc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2668723842

PECOS Enrollment IDI20190614000402

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Shorepoint Health Port Charlotte

Acute Care Hospitals · Port Charlotte, FL

1/5 CMS rating

OwnershipProprietary

CMS Certification Number100077

Location2500 Harbor BlvdPort Charlotte, FL 33952 · Charlotte County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 34972 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$87.62 typical visit price

range $56.00 – $171.84

Typical copayment $21.90 (range $14.00 – $42.96)

Most-billed visit code 99203

Established Patient

$99.16 typical visit price

range $17.57 – $139.16

Typical copayment $24.79 (range $4.39 – $34.79)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 5

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

5 suppliers14 claims40 services$4.97 avg. paid by Medicare

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

1 supplier19 claims19 services$7.80 avg. paid by Medicare

Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg J7613

DME-Drugs Administered Through DME · category DG006N

3 suppliers29 claims6,913 services$0.03 avg. paid by Medicare

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

2 suppliers18 claims18 services$185.81 avg. paid by Medicare

Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513

DME-Other DME · category DE000N

3 suppliers21 claims21 services$26.03 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NATHALIE GRANT

Nurse Practitioner (Family)