Active NPI
Kasey Wren Floyd Moore
- Physician Assistant
- Lake City, SC
National Provider Identifier
1144115239
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 604 E Main St
Lake City, SC 29560-2228 - Phone
- (803) 460-3254
- NPI assigned
- Jun 10, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
604 E Main St
Lake City, SC 29560-2228
Mailing address
3555 N Williamsburg County Hwy
Cades, SC 29518-3008
Phone (843) 210-5000
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | direct@direct.musc.edu | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1749513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786665600000",
"number": "1144115239",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3555 N WILLIAMSBURG COUNTY HWY",
"city": "CADES",
"state": "SC",
"postal_code": "295183008",
"telephone_number": "843-210-5000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "604 E MAIN ST",
"city": "LAKE CITY",
"state": "SC",
"postal_code": "295602228",
"telephone_number": "803-460-3254"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "KASEY WREN",
"middle_name": "FLOYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-06-10",
"last_updated": "2026-08-14",
"certification_date": "2026-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "direct@direct.musc.edu",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"address_1": "3555 N Williamsburg County Hwy",
"city": "Cades",
"state": "SC",
"country_code": "US",
"postal_code": "295183008",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Lake City, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.