Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kelli Moore

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1699243204

Kelli Moore is a Physician Assistant in Bingham Farms, Michigan. Qualified in 2019, 7 years ago. Practices as a sole proprietor and works from 2 locations. Licensed in Michigan.

Years since qualifying
7
Licensed in
MI
In the registry since
2018
Specialties on file
2

Practice location Address checks out

Student / training record This NPI belongs to someone enrolled in a health care training programme. It carries no licence and no practice of its own, so no address or phone number is published for it.

Bingham Farms, MI

Additional practice locations (1)

  • 9103 Country View Dr, Ypsilanti, MI 48197-6650 — (502) 649-2954

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5601009656 (MI)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1699243204
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedNovember 13, 2018
Last updated in NPPESAugust 16, 2020
Certification dateAugust 16, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

Other providers in Bingham Farms