Individual provider Active NPI

Nathaniel Kenneth Mosley, MD

  • Pediatric Critical Care Medicine Physician
  • Augusta, GA
National Provider Identifier
1124360003
Registry record updated May 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
85630 Issued in GA
Practice address
1120 15TH St
Augusta, GA 30912-2621
Phone
(706) 721-8623
NPI assigned
Mar 19, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 266751 MA
Pediatric Critical Care Medicine Physician 2080P0203X 266751 MA
Hospitalist Physician 208M00000X 266751 MA
Pediatric Critical Care Medicine Physician 2080P0203X 85630 GA Primary

Addresses

Primary practice location

1120 15TH St
Augusta, GA 30912-2621

Mailing address

1120 15TH St # Or6000
Augusta, GA 30912-0004
Phone (706) 721-3813

Other practice location 1

55 Fruit St
Massachusetts General Hospital for Children
Boston, MA 02114-2621
Phone (617) 724-4380

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200609000512 GA Practitioner - Pediatric MedicinePractitioner - Critical Care (Intensivists) 3678869468 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Critical Care (Intensivists)
Education
Medical College of Georgia School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

1120 15TH St
Augusta, GA 30912-0004
Phone (706) 721-8623

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

989 Saint Sebastian Way
Augusta, GA 30912-0004
Phone (706) 721-2171

Hospital & facility affiliations

  • Wellstar MCG Health, Affiliated With Med Col Hospital, Augusta, GA, CCN 110034

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
85630GAMDPediatric Critical Care Medicine Physician
266751MAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC Current Accepting new patients
Au Medical Associates Inc CurrentSince Jun 1, 2020 Accepting new patients
Au Medical Associates Inc CurrentSince Jun 1, 2020 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Sep 1, 2023 Accepting new patients
Au Medical Center, Inc Past Accepting new patients

Locations

1120 15th St
Augusta, GA 30912
Phone (706) 721-3873

1120 15th St
Ste BI1056
Augusta, GA 30912
Phone (706) 721-2785

1120 15th St
#6000
Augusta, GA 30912
Phone (706) 721-3813

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1363651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684108800000",
    "number": "1124360003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 15TH ST # OR6000",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309120004",
            "telephone_number": "706-721-3813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 15TH ST",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309122621",
            "telephone_number": "706-721-8623"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Fruit St",
            "address_2": "Massachusetts General Hospital for Children",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021142621",
            "country_code": "US",
            "telephone_number": "617-724-4380",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOSLEY",
        "first_name": "NATHANIEL",
        "middle_name": "KENNETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-19",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "266751",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "MA",
            "license": "266751",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MA",
            "license": "266751",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "GA",
            "license": "85630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.