Joseph S Moak Jr MD PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

JOSEPH S MOAK JR MD PA

Practice address

1040 Biglane Drive
Brookhaven, MS 39601

Phone

(601) 833-5051

Fax

(601) 835-0240

NPI assigned

Apr 15, 2014

Last updated

May 30, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Antha R. Restivo

Title

Office Manager

Phone

(601) 833-5051

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Joseph Samuel Moak Jr., MD

  • Internal Medicine Physician
  • Jackson, MS
  • NPI 1184667800
  Medicare reassignment NPD
• Edward Sidney Moak, M.D.

  • Internal Medicine Physician
  • Monticello, MS
  • NPI 1437266384
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1397520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401408000000",
    "number": "1043639289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 BIGLANE DRIVE",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "39601",
            "telephone_number": "601-833-5051",
            "fax_number": "601-835-0240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 BIGLANE DRIVE",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "39601",
            "telephone_number": "601-833-5051",
            "fax_number": "601-835-0240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSEPH S MOAK JR MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-15",
        "last_updated": "2014-05-30",
        "status": "A",
        "authorized_official_last_name": "RESTIVO",
        "authorized_official_first_name": "ANTHA",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "601-833-5051",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yaminah Johnson, FNP
• Clayton Hardy Johnston, D.M.D., P.A.
• Antranekia Johnte Jones, MSW
• Randall K Jones
• Brittany Lester Jordan, PHARM D
• Julie Ross, NP, PLLC Dba Brookhaven Neurobehavioral Clinic
• Janice Karas
• KCRX Brookhaven LLC
• KDMC Physician Clinics LLC
• Margaret Jane Kent, RPH

• Internal Medicine Physician in Brookhaven, MS
• Providers in Brookhaven, MS by specialty
• Internal Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.