Individual provider Active NPI

George William Mozingo III, M.D.

  • Urology Physician
  • Lumberton, NC
National Provider Identifier
1679568067
Registry record updated Mar 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
0000-29150 Issued in NC
Practice address
815 Oakridge Blvd
Lumberton, NC 28358-2330
Phone
(910) 738-7166
Fax
(910) 738-4434
NPI assigned
Sep 13, 2005
Last updated
Mar 1, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 0000-29150 NC Primary

Addresses

Primary practice location

815 Oakridge Blvd
Lumberton, NC 28358-2330

Mailing address

5221 Paramount Pkwy Ste 220
Morrisville, NC 27560-5490

Other identifiers 1

IdentifierTypeStateIssuer
8961269MedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gmozingo845480@direct.UNC.nchie.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20091123000338 NC Practitioner - Urology 3678612199 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Medical University of South Carolina College of Medicine, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Unc Physicians Network LLCGroup PAC ID 5496940546, 985 clinicians

Practice addresses (Care Compare)

815 Oakridge Blvd
Lumberton, NC 28358-2330
Phone (910) 738-7166

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29150NCMDPharmacist
0000-29150NCMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Regional Physician Services CurrentSince Mar 1, 2010 Accepting new patients
Southeastern Regional Physician Services CurrentSince Mar 1, 2010 Accepting new patients
Southeastern Regional Physician Services Current Accepting new patients
Unc Physicians Network LLC Urology CurrentSince Jun 1, 2022 Accepting new patients
Unc Physicians Network LLC Current Accepting new patients

Locations

940 Martin Luther King Jr Blvd
Chapel Hill, NC 27514
Phone (919) 942-5123

2002 N Cedar St
#B
Lumberton, NC 28358
Phone (910) 272-3048

2600 N Elm St
Lumberton, NC 28358
Phone (910) 671-5290

395 W 27th St
Lumberton, NC 28358
Phone (910) 738-3434

815 Oakridge Blvd
Lumberton, NC 28358
Phone (910) 738-7166

2000 Perimeter Park Dr
Ste 200
Morrisville, NC 27560
Phone (800) 594-8624

5221 Paramount Pkwy
Ste 220
Morrisville, NC 27560
Phone (984) 215-4110

Interoperability endpoints

  • Direct secure messaging: gmozingo845480@direct.unc.nchie.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709251200000",
    "number": "1679568067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5221 PARAMOUNT PKWY STE 220",
            "city": "MORRISVILLE",
            "state": "NC",
            "postal_code": "275605490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 OAKRIDGE BLVD",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283582330",
            "telephone_number": "910-738-7166",
            "fax_number": "910-738-4434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOZINGO",
        "first_name": "GEORGE",
        "middle_name": "WILLIAM",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-13",
        "last_updated": "2024-03-01",
        "certification_date": "2024-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NC",
            "license": "0000-29150",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8961269",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gmozingo845480@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "815 Oakridge Blvd",
            "city": "Lumberton",
            "state": "NC",
            "country_code": "US",
            "postal_code": "283582330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lumberton, NC

Sources for this page

Verify at the official NPI Registry.