NPIMap

Individual provider Active NPI

Katherine Moredock Hayden, PA-C

  • Medical Physician Assistant
  • Orangeburg, SC
National Provider Identifier
1811390313
Registry record updated Mar 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
2190 Issued in SC
Practice address
1175 Cook Rd Ste 215
Orangeburg, SC 29118-8201
Phone
(803) 395-3837
Fax
(803) 536-5122
NPI assigned
Sep 29, 2014
Last updated
Mar 27, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2190 SC
Medical Physician Assistant 363AM0700X 2190 SC Primary

Addresses

Primary practice location

1175 Cook Rd Ste 215
Orangeburg, SC 29118-8201

Mailing address

PO Box 12810
Belfast, ME 04915-4019
Phone (843) 797-5050

Other practice location 1

2880 Tricom Street
Charleston, SC 29406-9171
Phone (843) 797-5050

Other identifiers 4

IdentifierTypeStateIssuer
DU4331OtherSCARCIS HEALTHCARE RAILROAD MEDICARE GROUP PTAN
D043OtherSCARCIS HEALTHCARE MEDICARE GROUP PTAN
GP6337OtherSCARCIS HEALTHCARE MEDICAID GROUP NO.
1902246077OtherSCARCIS HEALTHCARE GROUP NPI NO.

Other names 1

  • Katherine R Moredock Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141224000053 SC Practitioner - Physician Assistant 6709109796 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Medical University of South Carolina College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Musc Community PhysiciansGroup PAC ID 6507260668, 1,353 clinicians

Practice addresses (Care Compare)

1175 Cook Rd
Orangeburg, SC 29118-8201
Phone (843) 792-1414

3000 Saint Matthews Rd
Orangeburg, SC 29118-1442
Phone (803) 395-3400

506 N St
Bamberg, SC 29003-1319
Phone (803) 245-6290

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.41 of 100Reported as group
Quality
64.93
Promoting interoperability
99
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2190SCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Musc Community Physicians CurrentSince Mar 1, 2023 Accepting new patients
Musc Community Physicians CurrentSince Mar 1, 2023 Accepting new patients
Regional Medical Center of Orangeburg and Calhoun Counties Past Accepting new patients

Locations

506 North St
Bamberg, SC 29003
Phone (803) 245-6290

1175 Cook Rd
Ste 215
Orangeburg, SC 29118
Phone (803) 395-3837

Interoperability endpoints

  • Direct secure messaging: kmoredock75822@direct.musc.edu

Organizations & group practices 4

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 6

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": "1411948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553644800000",
    "number": "1811390313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12810",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154019",
            "telephone_number": "843-797-5050",
            "fax_number": "843-797-3633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 COOK RD STE 215",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291188201",
            "telephone_number": "803-395-3837",
            "fax_number": "803-536-5122"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2880 Tricom Street",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294069171",
            "country_code": "US",
            "telephone_number": "843-797-5050",
            "fax_number": "843-797-3633",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAYDEN",
        "first_name": "KATHERINE",
        "middle_name": "MOREDOCK",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-29",
        "last_updated": "2019-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "2190",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "2190",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARCIS HEALTHCARE RAILROAD MEDICARE GROUP PTAN",
            "identifier": "DU4331",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARCIS HEALTHCARE MEDICARE GROUP PTAN",
            "identifier": "D043",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARCIS HEALTHCARE MEDICAID GROUP NO.",
            "identifier": "GP6337",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARCIS HEALTHCARE GROUP NPI NO.",
            "identifier": "1902246077",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "MOREDOCK",
            "middle_name": "R",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Orangeburg, SC

Sources for this page

Verify at the official NPI Registry.