Individual provider Active NPI

Kaitlyn Roberts Mozingo, FNP

  • Nurse Practitioner
  • Rock Hill, SC
National Provider Identifier
1881576502
Registry record updated Jul 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
30720 Issued in SC
Practice address
2633 Celanese Rd
Rock Hill, SC 29732-1205
Phone
(803) 325-1770
Fax
(803) 325-1790
NPI assigned
Jul 23, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 30720 SC
Nurse Practitioner 363L00000X 30720 SC Primary

Addresses

Primary practice location

2633 Celanese Rd
Rock Hill, SC 29732-1205

Mailing address

4250 Edgeland Rd
Edgemoor, SC 29712-7734
Phone (864) 321-7318

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20250819001694 SC Practitioner - Nurse Practitioner 9537668348 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Physician Network LLCGroup PAC ID 7911287552, 92 clinicians

Practice addresses (Care Compare)

2633 Celanese Rd
Rock Hill, SC 29732-1205
Phone (803) 325-1770

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Physician Network LLC Nurse Practitioner CurrentSince Jul 31, 2025 Accepting new patients

Locations

200 Herlong Ave S
Ste E
Rock Hill, SC 29732
Phone (803) 324-1950

2633 Celanese Rd
Rock Hill, SC 29732
Phone (803) 325-1770

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14929/brand/3/csg/1/fhir/r4
  • Direct secure messaging: kaitlyn.mozingo.1@14929.direct.athenahealth.com

Organizations & group practices 1

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": "1753228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753660800000",
    "number": "1881576502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4250 EDGELAND RD",
            "city": "EDGEMOOR",
            "state": "SC",
            "postal_code": "297127734",
            "telephone_number": "864-321-7318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2633 CELANESE RD",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321205",
            "telephone_number": "803-325-1770",
            "fax_number": "803-325-1790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOZINGO",
        "first_name": "KAITLYN",
        "middle_name": "ROBERTS",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-23",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "SC",
            "license": "30720",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "30720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, SC

Sources for this page

Verify at the official NPI Registry.