KELLEY B MOULE MSW, LMSW
NPI 1689984916
Social Worker - Clinical in Jackson, MS
About Kelley B Moule Msw, Lmsw NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KELLEY B MOULE MSW, LMSW (NPI 1689984916) is an individual clinical provider in Jackson, Mississippi, licensed in Mississippi (C9980) and active in the NPI registry since October 2010. She is enrolled in Medicare PECOS, maintains 5 additional practice locations, and is a graduate of Other (2008).
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Locations 5
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
Kelley B Moule Msw, Lmsw 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 Kelley Moule reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Raymond, NH 03077
- Reassigned Medicare billing, Mississippi enrollment
- 25 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 39209 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 12
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Kelley Moule's NPI number?
The NPI number for Kelley Moule is 1689984916. It was assigned to this individual provider in the NPPES registry on October 20, 2010.
Where is Kelley Moule located?
Kelley Moule practices at 911 Ellis Ave, Jackson, MS 39209. The listed phone number is (601) 533-7016.
What is Kelley Moule's specialty?
The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.
Is Kelley Moule enrolled in Medicare?
Yes. Kelley Moule 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 Kelley Moule's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kelley Moule reassigns Medicare benefits to Oak Street Health Physicians Group Of Mississippi, LLC (Raymond, NH). 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 Kelley Moule's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Kelley Moule was last updated on November 13, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months 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.
# Kelley B Moule, MSW, LMSW · NPI 1689984916
Clinical provider in Jackson, Mississippi. Individual provider, active in the CMS NPPES registry since October 20, 2010.
## Identity
- **NPI:** 1689984916 (Entity type: Individual)
- **Enumerated:** October 20, 2010
- **Primary specialty:** Social Worker - Clinical · taxonomy 1041C0700X
- **State license:** C9980 (Mississippi)
- **Sole proprietor:** No
## Practice location
- **Address:** 911 ELLIS AVE, Jackson, MS 39209-6256
- **Phone:** (601) 533-7016
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Oak Street Health Physicians Group Of Mississippi, LLC (NPI 1235754995, Raymond, NH), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2008
## Record status
- **NPPES last updated:** November 13, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1689984916) · Data from the CMS NPPES public registry.