Active NPI
Kathryn S Mock, FNP
- Family Nurse Practitioner
- Columbia, SC
National Provider Identifier
1770513103
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 2154
- Practice address
- 8301 Farrow Rd
Columbia, SC 29203-3245 - Phone
- (803) 255-3417
- Fax
- (803) 255-3451
- NPI assigned
- Jul 3, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 2154 | SC | Primary |
Addresses
Primary practice location
8301 Farrow Rd
Columbia, SC 29203-3245
Mailing address
15 Medical Park Rd
Suite 300
Columbia, SC 29203
Phone (803) 255-3417
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NP0964 | Medicaid | SC |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1770513103",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 MEDICAL PARK RD",
"address_2": "SUITE 300",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "29203",
"telephone_number": "803-255-3417",
"fax_number": "803-255-3451"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8301 FARROW RD",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292033245",
"telephone_number": "803-255-3417",
"fax_number": "803-255-3451"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOCK",
"first_name": "KATHRYN",
"middle_name": "S",
"name_prefix": "Ms.",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "SC",
"license": "2154",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "NP0964",
"state": "SC"
}
],
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.