Robert E Decoux Jr., MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

07001 Issued in MS

Practice address

300 Rawls Dr
Suite 1300
McComb, MS 39648-2877

Phone

(601) 249-3541

Fax

(601) 249-3544

NPI assigned

Aug 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MS

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/22116/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Amite County Medical Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Liberty, MS
  • NPI 1073634226
  Medicare reassignment NPD
• Amite County Medical Services, Inc.

  dba Pike County Medical Services

  • Federally Qualified Health Center (FQHC)
  • McComb, MS
  • NPI 1609242056
  NPD

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488326400000",
    "number": "1487662763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 511",
            "address_2": "102 WEST FREEDOM DRIVE",
            "city": "LIBERTY",
            "state": "MS",
            "postal_code": "396450511",
            "telephone_number": "601-657-4326",
            "fax_number": "601-657-8867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 RAWLS DR",
            "address_2": "SUITE 1300",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396482877",
            "telephone_number": "601-249-3541",
            "fax_number": "601-249-3544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECOUX",
        "first_name": "ROBERT",
        "middle_name": "E",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2017-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MS",
            "license": "07001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN ADMIN GROUP",
            "identifier": "1558935",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "100002670",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00012512",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Krystal Davis
• Racheal Davis
• Stacey Davis, RN
• Henry Leroy Dawkins, ACNP
• Charity Day
• Crystal Deer-Walker, LPN
• Micki Jo Deer
• Ronald Dwayne Delrie Jr., M.D.
• Mike Dempsey
• Cierra Denman, PCMHT

• General Practice Physician in McComb, MS
• Providers in McComb, MS by specialty
• General Practice Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.