Individual provider Active NPI

Katlyn Olivia Mauney, NP-C

  • Primary Care Nurse Practitioner
  • Shelby, NC
National Provider Identifier
1760978969
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
5012399 Issued in NC
Practice address
711 N Dekalb St
Shelby, NC 28150-3911
Phone
(704) 482-1482
NPI assigned
Jul 11, 2018
Last updated
Jul 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 22042 SC
Primary Care Nurse Practitioner 363LP2300X 5012399 NC Primary

Addresses

Primary practice location

711 N Dekalb St
Shelby, NC 28150-3911

Mailing address

121 Clinton St
Shelby, NC 28152-8196
Phone (704) 472-6073

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20190228002012 SC Practitioner - Nurse Practitioner 9335488782 Reassigns benefits to 3 organizations
I20191230001373 NC Practitioner - Nurse Practitioner 9335488782 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

201 E Grover St
Shelby, NC 28150-3917
Phone (704) 487-3131

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22042SCMDFamily Nurse Practitioner
5012399NCMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Shelby Medical Associates, PA CurrentSince Jul 1, 2024 Accepting new patients
Carolinas Emergency Physicians, P.a. CurrentSince Oct 15, 2019 Accepting new patients
Carolinas Emergency Physicians, P.a. CurrentSince Oct 15, 2019 Accepting new patients
Village Hospital CurrentSince Jan 6, 2020 Accepting new patients
App of South Carolina Ed PLLC CurrentSince Oct 8, 2018 Accepting new patients
Pelham Medical Center Current Accepting new patients
Spartanburg Medical Center CurrentSince Jan 6, 2020 Accepting new patients
Spartanburg Medical Center CurrentSince Jan 6, 2020 Accepting new patients
Pelham Medical Center CurrentSince Jan 6, 2020 Accepting new patients
Shelby Medical Associates, P.a. Past Accepting new patients

Locations

201 E Grover St
Shelby, NC 28150
Phone (704) 487-3000

711 N DeKalb St
Shelby, NC 28150
Phone (704) 482-1482

1530 N Limestone St
Gaffney, SC 29340
Phone (864) 487-1544

250 Westmoreland Rd
Greer, SC 29651
Phone (864) 530-2108

1304 W Bobo Newsom Hwy
Hartsville, SC 29550
Phone (469) 340-1366

101 E Wood St
Spartanburg, SC 29303
Phone (864) 560-1915

Interoperability endpoints

  • Direct secure messaging: kmauney247043@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 10

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": "1531267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1760978969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 CLINTON ST",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281528196",
            "telephone_number": "704-472-6073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 N DEKALB ST",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281503911",
            "telephone_number": "704-482-1482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAUNEY",
        "first_name": "KATLYN",
        "middle_name": "OLIVIA",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-11",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "22042",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NC",
            "license": "5012399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby, NC

Sources for this page

Verify at the official NPI Registry.