KIMBERLY WELLS MOORE (NP) – Family Nurse Practitioner, NPI 1013518661

KIMBERLY WELLS MOORE (NP) is a healthcare provider. based in Mount olivet, Kentucky. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. 3014345 (KY). The NPI Number for KIMBERLY WELLS MOORE (NP) is 1013518661

Main info

Female
7 Years Of Experience
Name
KIMBERLY WELLS MOORE (NP)
NPI
1013518661
Phone
(606) 842-0258
Address
1196 SARDIS RD
Enumeration Date
2 November 2020
Last Update Date
18 November 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7185340689
Graduation Year
2019 (7 years ago)
PAC ID
3779016019
Group Practice PAC ID
4880071299
Professional Enrollment ID
I20241025000434
Address ID
KY411013677AS1820XRDXX300
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:5State licenses:3Digital endpointsOther names

7,347 NURSE PRACTITIONER in KY

Provider Addresses for KIMBERLY WELLS MOORE (NP)

  • 1196 SARDIS RD

    MOUNT OLIVET, KY 410647580

    Phone: (606) 842-0258

    Type: Location

  • PO BOX 341

    MOUNT OLIVET, KY 410640341

    Phone: (606) 842-0258

    Type: Mailing

  • 1030 KENTONTOWN RD

    MOUNT OLIVET, KY 410647649

    Phone: (606) 724-5020

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $21.

Total Amount is formed as General ($21) + Research ($0) + Ownership ($0) = $21.

Last reported payment date: 2024-04-18 • Largest payer in this snapshot: Integra LifeSciences Corporation ($21).

Total Amount

$21

General + Research + Ownership

Payments

1

Total payment records

General Amount

$21

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-04-18

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2024-10-25

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20241025000434INurse PractitionerKYTBD

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.

Verify on CMS Revalidation Lookup Tool

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 41064)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4880071299View full group profile
NameSpecialtyState
Nurse PractitionerKY
Nurse PractitionerKY
Nurse PractitionerKY
Nurse PractitionerKY
Nurse PractitionerNV
Nurse PractitionerTN
Nurse PractitionerOH
Nurse PractitionerKY
Nurse PractitionerSC

Reviews

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Frequently asked questions

What is the standard ID for KIMBERLY WELLS MOORE (NP) in the U.S.?
In the U.S., KIMBERLY WELLS MOORE (NP) is identified by NPI 1013518661.
Is KIMBERLY WELLS MOORE (NP)'s NPI status active today?
Active status means KIMBERLY WELLS MOORE (NP)'s NPI record is not deactivated in the public file.
What does the directory say KIMBERLY WELLS MOORE (NP) does?
Insurance directories may phrase it differently, but here KIMBERLY WELLS MOORE (NP) maps to Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Is KIMBERLY WELLS MOORE (NP) tied to Mount Olivet, Kentucky?
If you are local to Mount Olivet, Kentucky, KIMBERLY WELLS MOORE (NP) may be relevant to your search.
Can I export KIMBERLY WELLS MOORE (NP)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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