Mailyn Marie Mozingo, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R40973 Issued in ND

Practice address

510 4TH St S
Fargo, ND 58103-1914

Phone

(701) 476-7200

NPI assigned

Oct 9, 2023

Last updated

Jun 18, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ND

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

PSJ Acquisition LLCGroup PAC ID 7012062235, 26 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• PSJ Acquisition LLC

  dba Prairie St John's

  • Psychiatric Hospital
  • Fargo, ND
  • NPI 1679709802

  Single Specialty

  Medicare reassignment Care Compare group NPD
• PSJ Acquisition LLC

  dba Prairie St. John's

  • Psychologist
  • Fargo, ND
  • NPI 1720454267
  NPD

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

{
    "created_epoch": "1696809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1639950348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 LIONHEART DRIVE",
            "city": "HORACE",
            "state": "ND",
            "postal_code": "58047",
            "telephone_number": "701-204-2804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 4TH ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581031914",
            "telephone_number": "701-476-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOZINGO",
        "first_name": "MAILYN",
        "middle_name": "MARIE",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-09",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ND",
            "license": "R40973",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "ND",
            "license": "R40973",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Marie Motacek, O.D.
• Motivate Minds LLC
• Krista Marie Mougey
• Adrianna Moum, DO
• Move Chiropractic LLC
• Justin Felix Mozinski I, NP
• Morgan Alexandra Mozinski, NP
• Gilbert S Mrema
• MRG Inc (Garrys Opticians)
• MS4 PLLC (The Medicine Shoppe Long Term Care)

• Psychiatric/Mental Health Nurse Practitioner in Fargo, ND
• Providers in Fargo, ND by specialty
• Psychiatric/Mental Health Nurse Practitioner in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.