James Nelson Mock, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

62661 Issued in TN

Practice address

405 W Jackson St
Carbondale, IL 62901-1462

Phone

(618) 549-0721

Fax

(618) 457-0469

NPI assigned

Aug 11, 2006

Last updated

Sep 23, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC, NC2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Emergency Medicine

Education

University of North Carolina at Chapel Hill School of Medicine, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ies South Carolina LLCGroup PAC ID 1355705070, 16 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Carolina Pines Regional Medical Center Hospital, Hartsville, SC, CCN 420010

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

97.83

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
• Direct secure messaging: jmock82386@directmcleodehealth.org

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.

• Ies South Carolina LLC

  • Emergency Medicine Physician
  • Hartsville, SC
  • NPI 1821779695
  Medicare reassignment Care Compare group NPD
• Acs Primary Care Physicians - Southeast PC

  • Emergency Medicine Physician
  • Myrtle Beach, SC
  • NPI 1861430555
  Medicare reassignment NPD
• App of South Carolina Ed PLLC

  • Emergency Medicine Physician
  • Hartsville, SC
  • NPI 1457878084
  Medicare reassignment NPD
• Conway Hospital Emergency Professional Services

  • Emergency Medicine Physician
  • Conway, SC
  • NPI 1487844510
  Medicare reassignment NPD
• Ich ER Services, LLC

  • Emergency Medicine Physician
  • Anderson, SC
  • NPI 1174002059
  Medicare reassignment NPD
• Kernersville Emergency Group, PLLC

  • Emergency Medicine Physician
  • Kernersville, NC
  • NPI 1750852034
  Medicare reassignment NPD
• Piedmont Triad Physicians, PLLC

  • Emergency Medicine Physician
  • Thomasville, NC
  • NPI 1295206464
  Medicare reassignment NPD
• Tanglewood Park Physicians, PLLC

  • Emergency Medicine Physician
  • Clemmons, NC
  • NPI 1093286379
  Medicare reassignment NPD
• Sound Physicians Emergency Medicine of South Carolina LLC

  • Emergency Medicine Physician
  • Aiken, SC
  • NPI 1730636168
  Medicare reassignment
• Midway Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Waukegan, IL
  • NPI 1447397526
  NPD (past)
• Emergency Physician Specialists Inc

  • Emergency Medicine Physician
  • Davenport, FL
  • NPI 1912973850
  NPD (past)
• Marion Physician Services LLC

  • Family Medicine Physician
  • Mullins, SC
  • NPI 1588985857
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Hartsville, LLC

  dba Carolina Pines Regional Medical Center

  • General Acute Care Hospital
  • Hartsville, SC
  • NPI 1174500458
  Care Compare affiliation

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632355200000",
    "number": "1093726226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 S HIGHLAND WAY",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295723362",
            "telephone_number": "843-457-4747",
            "fax_number": "843-497-6405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 W JACKSON ST",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629011462",
            "telephone_number": "618-549-0721",
            "fax_number": "618-457-0469"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 S 14th St",
            "address_purpose": "LOCATION",
            "city": "Herrin",
            "state": "IL",
            "postal_code": "629483631",
            "country_code": "US",
            "telephone_number": "618-942-2171",
            "fax_number": "618-988-6186",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 S Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Murphysboro",
            "state": "IL",
            "postal_code": "629663333",
            "country_code": "US",
            "telephone_number": "618-684-3156",
            "fax_number": "618-529-0524",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOCK",
        "first_name": "JAMES",
        "middle_name": "NELSON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036082903",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "16733",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "62661",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "167330",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vanessa Miranda, BA
• Arslan Mirza, M.D
• Ashley Nicole Mitchell, APRN, FNP-BC
• Carrie Darrow Mitros
• Alicia Faye Mocaby
• Yasoda Modali, M.D
• Kali Jo Moe, FNP-C
• Cathy S Moehring, LCPC
• Kaci Moeller, PTA
• Ibraheem Javeed Mohammed

• Emergency Medicine Physician in Carbondale, IL
• Providers in Carbondale, IL by specialty
• Emergency Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.