Individual provider Active NPI

Kimberly Celeste Mouzon, APRN

  • Acute Care Nurse Practitioner
  • Columbia, SC
National Provider Identifier
1689024473
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
20236 Issued in SC
Practice address
3016 Longtown Commons Dr Ste 100
Columbia, SC 29229-7862
Phone
(803) 314-0500
Fax
(803) 314-0501
NPI assigned
Jun 13, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 20236 SC Primary
Family Nurse Practitioner 363LF0000X 20236 SC

Addresses

Primary practice location

3016 Longtown Commons Dr Ste 100
Columbia, SC 29229-7862

Mailing address

PO Box 6069
West Columbia, SC 29171-6069
Phone (803) 791-2000

Other practice location 1

1041 N China Lake Blvd
Ridgecrest, CA 93555-3168
Phone (760) 446-3551

Other practice location 2

4621 Hard Scrabble Rd
Columbia, SC 29229-8584
Phone (803) 736-8955

Other names 1

  • Ms. Kimberly Celeste James Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Other URL unknown Other
Direct Messaging Address kmouzon159785@direct.lexmed.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, MD, SC, DC4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20161109002617 CA Practitioner - Nurse Practitioner 5799064051 Reassigns benefits to 1 organization
I20180827000143 MD Practitioner - Nurse Practitioner 5799064051 Reassigns benefits to 2 organizations
I20210621001790 SC Practitioner - Nurse Practitioner 5799064051 Reassigns benefits to 1 organization
I20220103002024 DC Practitioner - Nurse Practitioner 5799064051 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of South Carolina School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lexington Health IncGroup PAC ID 2567872070, 905 clinicians

Practice addresses (Care Compare)

3016 Longtown Commons Dr
Columbia, SC 29229-7849

7035 Saint Andrews Rd
Columbia, SC 29212-1177
Phone (803) 407-4100

7037 Saint Andrews Rd
Columbia, SC 29212-1177
Phone (803) 732-0963

7043 Saint Andrews Rd
Columbia, SC 29212-1177
Phone (803) 791-2683

7045 Saint Andrews Rd
Columbia, SC 29212-1177
Phone (803) 936-7590

811 W Main St
Lexington, SC 29072-2500

811 W Main St
Lexington, SC 29072-2507
Phone (803) 358-6120

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.09 of 100Reported as group
Quality
68.87
Promoting interoperability
100
Improvement activities
40
Cost
78.11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
20236SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lexington Health Inc CurrentSince Nov 1, 2022 Accepting new patients
Lexington Health Inc CurrentSince Nov 1, 2022 Accepting new patients
Medstar Medical Group II LLC CurrentSince Sep 15, 2019 Accepting new patients
Medstar Urgent Care LLC CurrentSince Dec 17, 2018 Accepting new patients
Medstar Urgent Care, LLC Current Accepting new patients
Chase Dennis Emergency Medical Group Inc CurrentSince Oct 10, 2016 Accepting new patients
Lexington Health Inc Current Accepting new patients
Medstar Urgent Care LLC CurrentSince Dec 17, 2018 Accepting new patients
Medstar Medical Group II LLC CurrentSince Sep 15, 2019 Accepting new patients
Medstar Urgent Care LLC Current Accepting new patients
Lexington County Health Services District, Inc. Past Accepting new patients

Locations

1200 B Gale Wilson Blvd
Fairfield, CA 94533
Phone (707) 429-3600

1081 N China Lake Blvd
Ridgecrest, CA 93555
Phone (760) 446-0616

2001 Medical Pkwy
Annapolis, MD 21401
Phone (410) 280-5601

6317 York Rd
Baltimore, MD 21212
Phone (443) 777-6890

12 Medstar Blvd
Bel Air, MD 21015
Phone (410) 877-8087

1406 Crain Hwy S
Glen Burnie, MD 21061
Phone (410) 768-6440

5009 Honeygo Center Dr
Ste 216
Perry Hall, MD 21128
Phone (410) 235-5405

3064 Waldorf Market Pl
Waldorf, MD 20603
Phone (301) 932-5960

11915 Georgia Ave
Wheaton, MD 20902
Phone (301) 942-4505

1111 Knox Abbott Dr
Cayce, SC 29033
Phone (803) 314-0660

557 Columbia Ave
Chapin, SC 29036
Phone (803) 932-0655

3016 Longtown Commons Dr
Ste 100
Columbia, SC 29229
Phone (803) 314-0500

7035 Saint Andrews Rd
Columbia, SC 29212
Phone (803) 749-0924

154 Saluda Pointe Dr
Lexington, SC 29072
Phone (803) 785-3580

811 W Main St
Ste 101
Lexington, SC 29072
Phone (803) 936-7230

811 W Main St
Lexington, SC 29072

2000 15th St N
Ste 600
Arlington, VA 22201
Phone (202) 425-0000

Organizations & group practices 11

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

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": "1465776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1689024473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6069",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291716069",
            "telephone_number": "803-791-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3016 LONGTOWN COMMONS DR STE 100",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292297862",
            "telephone_number": "803-314-0500",
            "fax_number": "803-314-0501"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1041 N China Lake Blvd",
            "address_purpose": "LOCATION",
            "city": "Ridgecrest",
            "state": "CA",
            "postal_code": "935553168",
            "country_code": "US",
            "telephone_number": "760-446-3551",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4621 Hard Scrabble Rd",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292298584",
            "country_code": "US",
            "telephone_number": "803-736-8955",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOUZON",
        "first_name": "KIMBERLY",
        "middle_name": "CELESTE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-13",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "SC",
            "license": "20236",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "20236",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "unknown",
            "affiliation": "N",
            "endpointDescription": "unknown",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "unknown",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "unknown",
            "address_1": "4621 Hard Scrabble Rd",
            "city": "Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "292298584",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmouzon159785@direct.lexmed.com",
            "affiliation": "N",
            "address_1": "3016 Longtown Commons Dr Ste 100",
            "city": "Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "292297862",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "JAMES",
            "middle_name": "CELESTE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.