Jack Moncrief Group, PA

Primary specialty

Pediatric Nephrology PhysicianTaxonomy code 2080P0210X

Legal business name

JACK MONCRIEF GROUP, PA

Practice address

800 West 34TH Street
Suite 101
Austin, TX 78705

Phone

(512) 485-7870

Fax

(512) 485-7876

NPI assigned

Nov 24, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Jack Wesly Moncrief, MD

Title

Owner

Phone

(512) 485-7870

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1259020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259020800000",
    "number": "1194053496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 WEST 34TH STREET",
            "address_2": "SUITE 101",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78705",
            "telephone_number": "512-485-7870",
            "fax_number": "512-485-7876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WEST 34TH STREET",
            "address_2": "SUITE 101",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78705",
            "telephone_number": "512-485-7870",
            "fax_number": "512-485-7876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACK MONCRIEF GROUP, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-24",
        "last_updated": "2009-11-24",
        "status": "A",
        "authorized_official_last_name": "MONCRIEF",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "WESLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-485-7870",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2080P0210X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1311987-04",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kamil Jaber, M.D.
• Jables Industries, Inc.
• Jack Jones Hearing Centers, Inc
• Jack Jones Hearing Centers, Inc.
• Jack Jones Hearing Centers, Inc.
• Jack Pierce,MD PLLC
• Christina Jack
• Jessica Ann Jackel, DACCHM, L.AC.
• Jackie West Physical Therapy
• Jackman Eye

• Pediatric Nephrology Physician in Austin, TX
• Providers in Austin, TX by specialty
• Pediatric Nephrology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.