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

Katherine Moody, PA

Individual provider Medical Physician Assistant · NPI 1194809400

Katherine Moody, PA is a Physician Assistant in Edina, Minnesota. Qualified in 2005, 21 years ago. Practices with Fairview Express Care, a 1,964-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Illinois and Minnesota.

Years since qualifying
21
Licensed in
IL, MN
In the registry since
2006
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

6405 France Ave S Ste W200
Edina, MN 55435-2163
Phone: (952) 924-9005
Fax: (952) 915-2443
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 10589 (MN)
Medical Physician Assistant Taxonomy 363AM0700X · Licence 085-002505 (IL)

Record details

NPI number1194809400
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedOctober 24, 2006
Last updated in NPPESAugust 13, 2009

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice Fairview Express Care — 1964 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations7 on file with Medicare

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