Ellie Bryan Mozingo, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

15050 Issued in SC

Practice address

125 Alpine Circle
Columbia, SC 29223

Phone

(803) 779-3548

Fax

(803) 779-7055

NPI assigned

Feb 17, 2006

Last updated

Jul 20, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in SC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: emozingo382568@direct.ghs.myhfn.org

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

• Carolina Family Care, Inc

  dba MUSC Physicians PCP

  • Family Medicine Physician
  • Charleston, SC
  • NPI 1184655722
  Medicare reassignment NPD
• Musc Community Physicians

  dba MUSC Community Physicians Specialty

  • Internal Medicine Physician
  • Bamberg, SC
  • NPI 1841878006
  Medicare reassignment NPD
• Midlands Psychiatric Service, LLC

  • Psychologist
  • Columbia, SC
  • NPI 1679782205
  Authorized official Same address or phone
• Carolina Family Care, Inc

  dba MUSC Physicians PC

  • Family Medicine Physician
  • Florence, SC
  • NPI 1093076457
  NPD
• Musc Community Physicians

  dba MUSC Health Primary Care - Bowman

  • Rural Health Clinic/Center
  • Bowman, SC
  • NPI 1225735772
  NPD
• Sandhills Psychiatric Associates, LLC

  dba Jason Kearnes, MD

  • Psychiatry Physician
  • Columbia, SC
  • NPI 1992472369
  NPD (past)

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

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626739200000",
    "number": "1316912066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 ALPINE CIRCLE",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29223",
            "telephone_number": "803-779-3548",
            "fax_number": "803-779-7055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 ALPINE CIRCLE",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29223",
            "telephone_number": "803-779-3548",
            "fax_number": "803-779-7055"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11 Richland Medical Park Dr",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292036863",
            "country_code": "US",
            "telephone_number": "803-434-4300",
            "fax_number": "803-434-4351",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOZINGO",
        "first_name": "ELLIE",
        "middle_name": "BRYAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-17",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SC",
            "license": "15050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PALMETTO HEALTH",
            "identifier": "582296052001",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150507",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "400186",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samantha Marie Mouser, RBT
• Shaka Abdul Moustafa I, PH.D
• John Andrew Mouzakis, M.D.
• Kimberly Celeste Mouzon, APRN
• Brianna Dominique Mozee
• Mr Therapy
• Matthew William Mubarak, M.D.
• Philip F Mubarak, MD
• Abigail Nora Mudd, RBT
• Alicia Muellenbach, PHARMD

• Psychiatry Physician in Columbia, SC
• Providers in Columbia, SC by specialty
• Psychiatry Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.