Kacie Jo Costello Moody, PA in Fort Mill, SC - Medicare Physician Assistant

Kacie Jo Costello Moody, PA is a medicare enrolled "Physician Assistant" in Fort Mill, South Carolina. She went to Medical University Of South Carolina College Of Medicine and graduated in 2006 and has 18 years of diverse experience with area of expertise as Physician Assistant. She is a member of the group practice Liberty Doctors Llc and her current practice location is 704 Gold Hill Rd, Suite 1200, Fort Mill, South Carolina. You can reach out to her office (for appointments etc.) via phone at (704) 667-3380.

Kacie Jo Costello Moody is licensed to practice in South Carolina (license number 1295) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1841461373.

Contact Information

	Kacie Jo Costello Moody, PA
	704 Gold Hill Rd, Suite 1200, Fort Mill, SC 29715-8906
	(704) 667-3380
	(704) 667-3381

Map and Direction

Provider's Profile

Full Name	Kacie Jo Costello Moody
Gender	Female
Speciality	Physician Assistant
Experience	18 Years
Location	704 Gold Hill Rd, Fort Mill, South Carolina
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Kacie Jo Costello Moody attended and graduated from Medical University Of South Carolina College Of Medicine in 2006

NPI Data:

NPI Number: 1841461373
Provider Enumeration Date: 03/12/2008
Last Update Date: 07/21/2022

Medicare PECOS Information:

PECOS PAC ID: 1456426139
Enrollment ID: I20080814000236

Medical Identifiers

Medical identifiers for Kacie Jo Costello Moody such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1841461373	NPI	-	NPPES
0640PA	Medicaid	SC
1841461373	Medicaid	NC

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363A00000X	Physician Assistant	0010-00779 (North Carolina)	Secondary
363A00000X	Physician Assistant	1295 (South Carolina)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Trident Medical Center	Charleston, SC	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Liberty Doctors Llc	0840466017	40

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kacie Jo Costello Moody is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Kacie Jo Costello Moody, PA Po Box 602148, Charlotte, NC 28260-2148 Ph: (704) 667-3380	Kacie Jo Costello Moody, PA 704 Gold Hill Rd, Suite 1200, Fort Mill, SC 29715-8906 Ph: (704) 667-3380

Reviews and Comments

Physician Assistant Nurses in Fort Mill, SC

Chelsea Mae Navarrett Woo, PA Physician Assistant Medicare: Medicare Enrolled Practice Location: 1852 Highway 160 W, Fort Mill, SC 29708 Phone: 704-667-5800
Bernadette Powell, Physician Assistant Medicare: Medicare Enrolled Practice Location: 9395 Founders St, Fort Mill, SC 29708 Phone: 864-404-8424
Mrs. Emma Cecilia Jusseaume, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 1698 Highway 160 W, Suite 200, Fort Mill, SC 29708 Phone: 803-547-4343 Fax: 803-547-3914
Mrs. Nicole C Keeter, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1700 1st Baxter Xing Ste 101, Fort Mill, SC 29708 Phone: 803-802-3376 Fax: 803-802-3329
Mrs. Courtney Marie Casey, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 502 Sixth Baxter Xing, Fort Mill, SC 29708 Phone: 803-396-8100 Fax: 803-396-8040
Anne Sexton, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 908 Smithfield Way Ste 101, Fort Mill, SC 29715 Phone: 803-220-2782 Fax: 803-233-2968
Dayle De Graaf, Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 1212 Trinity Ridge Pkwy, Fort Mill, SC 29715 Phone: 513-507-8330

Kacie Jo Costello Moody, PA - Medicare Physician Assistant in Fort Mill, SC