KHAMPHOU MANIVANH MOSLEY (FNP-BC) – Family Nurse Practitioner, NPI 1093205049
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
10,656 NURSE PRACTITIONER in TN
Provider Addresses for KHAMPHOU MANIVANH MOSLEY (FNP-BC)
5827 CORPORATE WAY
WEST PALM BEACH, FL 334072000
Phone: (561) 844-9443
Fax: (561) 472-9692
Type: Mailing
Perimeter Parkway, Northlake, Charlotte, Mecklenburg County, North Carolina, 28087, United States
CHARLOTTE, NC 282160197
Phone: (888) 849-7379
Fax: (855) 857-7333
Type: Mailing
2636 Elm Hill Pike
Nashville, TN 372143162
Phone: (347) 761-3230
Type: Location
10130 Perimeter Pkwy Ste 200
Charlotte, NC 282160197
Phone: (888) 849-7379
Fax: (855) 857-7333
Type: Location
1100 N PARROTT AVE
OKEECHOBEE, FL 349722129
Phone: (863) 763-7481
Fax: (844) 542-4899
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 27 Open Payments records for all available years, with a total value of $753.
Total Amount is formed as General ($753) + Research ($0) + Ownership ($0) = $753.
Last reported payment date: 2024-12-08 • Largest payer in this snapshot: GlaxoSmithKline, LLC. ($129).
Total Amount
$753
General + Research + Ownership
Payments
27
Total payment records
General Amount
$753
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-08
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| GlaxoSmithKline, LLC. | $129 |
| ABBVIE INC. | $124 |
| Dexcom, Inc. | $124 |
| Intuitive Surgical, Inc. | $71 |
| Lilly USA, LLC | $50 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2019-06-14
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20190614000402 | I | Nurse Practitioner | FL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 33407)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| N E P H R O L O G Y | FL | |
| Nephrology, Internal Medicine | FL | |
| N E P H R O L O G Y | FL | |
| N E P H R O L O G Y | FL | |
| Nephrology, Internal Medicine | FL | |
| N E P H R O L O G Y | FL | |
| Internal Medicine, Nephrology | FL | |
| Nephrology, Internal Medicine | FL | |
| N E P H R O L O G Y | FL | |
| Nurse Practitioner | FL |
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