Individual provider Active NPI

Carly Dorothy Mobley, MD

  • Neonatal-Perinatal Medicine Physician
  • Columbia, SC
National Provider Identifier
1629506639
Registry record updated Sep 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
93186 Issued in SC
Practice address
5 Richland Medical Park Dr
Columbia, SC 29203-6863
Phone
(803) 434-7000
NPI assigned
Jun 2, 2017
Last updated
Sep 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 93186 SC Primary

Addresses

Primary practice location

5 Richland Medical Park Dr
Columbia, SC 29203-6863

Mailing address

700 Woodrow St Unit 511
Columbia, SC 29205-1772
Phone (704) 577-5461

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
93186SCMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health-Midlands Past Accepting new patients
Prisma Health-Midlands Past Accepting new patients
Lexington Health Inc Past Accepting new patients
Prisma Health-Midlands Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1496361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1629506639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 WOODROW ST UNIT 511",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292051772",
            "telephone_number": "704-577-5461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 RICHLAND MEDICAL PARK DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036863",
            "telephone_number": "803-434-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOBLEY",
        "first_name": "CARLY",
        "middle_name": "DOROTHY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-02",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "SC",
            "license": "93186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.