Organization Active NPI

Crescentworld Enterprises, PLLC

  • Internal Medicine Physician
  • Jackson, MS
National Provider Identifier
1124436977
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CRESCENTWORLD ENTERPRISES, PLLC
Practice address
406 Briarwood Dr Ste 401
Jackson, MS 39206-3063
Phone
(601) 707-7899
Fax
(866) 304-0148
NPI assigned
Jul 24, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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

Authorized official

Name
Berthrone Mock-Muhammad, MD, FACCNPI 1285781153
Title
Physician Owner
Phone
(601) 707-7899

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X
Cardiopulmonary Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251C2600X
Clinical Electrophysiology Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251E1300X
Massage TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225700000X

Addresses

Primary practice location

406 Briarwood Dr Ste 401
Jackson, MS 39206-3063

Mailing address

PO Box 5025
Jackson, MS 39296-5025
Phone (601) 707-7899

Other identifiers 2

IdentifierTypeStateIssuer
1285781153OtherMSNPI
03925069MedicaidMS

Other names 2

  • Heart Plus Center Doing business as
  • HeartPLUS Diagnostic Clinic /Celestial Health & Wellness Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141224000113 MS Part B Supplier - Clinic/Group Practice 3870816861 Receives reassigned benefits from 1 practitioner
Practice locations: Jackson, MS

National Provider Directory

National Provider Directory

Locations

406 Briarwood Dr
Ste 401
Jackson, MS 39206
Phone (601) 326-2300

670 Highway 51
Ste B
Ridgeland, MS 39157
Phone (601) 707-7899

297 Highway 51
Ridgeland, MS 39157

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1406160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695686400000",
    "number": "1124436977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5025",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392965025",
            "telephone_number": "601-707-7899",
            "fax_number": "866-304-0148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 BRIARWOOD DR STE 401",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392063063",
            "telephone_number": "601-707-7899",
            "fax_number": "866-304-0148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESCENTWORLD ENTERPRISES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-24",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A",
        "authorized_official_last_name": "MOCK-MUHAMMAD",
        "authorized_official_first_name": "BERTHRONE",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "601-707-7899",
        "authorized_official_credential": "MD, FACC"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251C2600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Cardiopulmonary",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251E1300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Electrophysiology, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1285781153",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03925069",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heart Plus Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "HeartPLUS Diagnostic Clinic /Celestial Health & Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2023; 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.