Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Shane Mozingo

Individual provider Family Nurse Practitioner · NPI 1295347474

Shane Mozingo is a Nurse Practitioner in North Logan, Utah. Qualified in 2023, 3 years ago. Practices with Atlas Medical Alaska LLC, a 6-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Utah.

Years since qualifying
3
Licensed in
UT
In the registry since
2020

Practice location Address checks out

2841 N 920 E
North Logan, UT 84341-5806
Phone: (435) 512-1066
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 10646550-3102 (UT)

Record details

NPI number1295347474
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedAugust 19, 2020
Last updated in NPPESDecember 14, 2020
Certification dateDecember 14, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Atlas Medical Alaska Llc — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in North Logan