Look up the most recent NPI and PECOS records

Kelli Jo Moore

Radiology

Allopathic & Osteopathic Physicians

PECOS Enrollment

This provider is enrolled in PECOS as KELLI MOORE.

Based on the most recent information from CMS, provider Kelli Jo Moore is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1427391846
Provider Type
Individual
Full Name
Moore, Kelli Jo
Title
Dr.
Credential
M.D.

Gender
Female
Sole Proprietor
No
Enumeration Date
4/3/2013
Last Updated
9/23/2019

Contact Information

Practice Location

One Hospital Dr, Columbia, MO 65212

(573) 882-9055

(573) 884-4406

Mailing Location

PO Box 843966, Kansas City, MO 64184-3966

(573) 884-3300

(573) 884-0943

Provider Taxonomies

Code	Description	License
Code 2085R0202X Primary	Description Radiology Allopathic & Osteopathic Physicians	License 2019022284 Missouri
Code 2085R0202X	Description Radiology Allopathic & Osteopathic Physicians	License 62996 Wisconsin

Kelli Jo Moore

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Cleek, John

Thimmappa, Nanda Deepa

Mahdi, Eman S

Sethi, Yash Pal

Velnati, Aparna

Maqbool, Maaz Sohail

Churchill, Robert J

Vaslow, Dale F

Singh, Amolak

Baqar, Mohammad