MRS. KELLY MARIE MOORE APRN, NP
NPI 1629632229
Nurse Practitioner - Family in Muskogee, OK
About Mrs. Kelly Marie Moore Aprn, Np NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MRS. KELLY MARIE MOORE APRN, NP (NPI 1629632229) is an individual family provider in Muskogee, Oklahoma, licensed in Oklahoma (109418) and active in the NPI registry since April 2019. She is enrolled in Medicare PECOS and is a graduate of Other (2018).
NPPES Registry Identity
Specialties & Licenses 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Mrs. Kelly Marie Moore Aprn, Np 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.
Medicare Billing Reassignment
Medicare enrollment records show Kelly Moore reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Lawton, OK 73505
- Reassigned Medicare billing, Oklahoma enrollment
- 249 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 7
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 74401 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 4
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
MUSKOGEE, OK 74401
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Kelly Moore's NPI number?
The NPI number for Kelly Moore is 1629632229. It was assigned to this individual provider in the NPPES registry on April 29, 2019.
Where is Kelly Moore located?
Kelly Moore practices at 550 W Shawnee St, Muskogee, OK 74401. The listed phone number is (918) 935-3636.
What is Kelly Moore's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Kelly Moore enrolled in Medicare?
Yes. Kelly Moore is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Kelly Moore's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kelly Moore reassigns Medicare benefits to Williams Medical Group Practice, LLC (Lawton, OK). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kelly Moore's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Kelly Moore accept?
Health plans from Blue Cross and Blue Shield of Oklahoma and Mending Health list Kelly Moore as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Kelly Moore was last updated on March 1, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Mrs. Kelly Marie Moore, APRN, NP · NPI 1629632229
Family physician in Muskogee, Oklahoma. Individual provider, active in the CMS NPPES registry since April 29, 2019.
## Identity
- **NPI:** 1629632229 (Entity type: Individual)
- **Enumerated:** April 29, 2019
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 109418 (Oklahoma)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 550 W SHAWNEE ST, Muskogee, OK 74401-4144
- **Phone:** (918) 935-3636
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Williams Medical Group Practice, LLC (NPI 1346608809, Lawton, OK), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2018
## Record status
- **NPPES last updated:** March 1, 2022
---
Source: [NPI Profile](https://npiprofile.com/npi/1629632229) · Data from the CMS NPPES public registry.