Individual provider Active NPI

Benjamin C Mozie, MD

  • Internal Medicine Physician
  • Jacksonville, NC
National Provider Identifier
1639195019
Registry record updated Mar 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2010-01876 Issued in NC
Practice address
1102 Henderson Dr
Jacksonville, NC 28540-5203
Phone
(910) 333-9712
Fax
(910) 333-9715
NPI assigned
Jul 15, 2006
Last updated
Mar 28, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2010-01876 NC Primary

Addresses

Primary practice location

1102 Henderson Dr
Jacksonville, NC 28540-5203

Mailing address

29 Office Park Dr
Jacksonville, NC 28546-3219
Phone (910) 333-9712

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20110307000807 NC Practitioner - Internal Medicine 3072518372 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

29 Office Park Dr
Jacksonville, NC 28546-3219
Phone (910) 333-9712

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Shalom Medical PC CurrentSince Jan 28, 2011 Accepting new patients
Dexter Emergency Physicians, LLC Past Accepting new patients
Twin Rivers Emergency Physicians, LLC Past Accepting new patients

Locations

1102 Henderson Dr
Jacksonville, NC 28540
Phone (910) 333-9712

29 Office Park Dr
Jacksonville, NC 28546
Phone (910) 333-9712

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FGACBA/Endpoint/FGACBA

Organizations & group practices 3

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522195200000",
    "number": "1639195019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 OFFICE PARK DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285463219",
            "telephone_number": "910-333-9712",
            "fax_number": "910-333-9715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 HENDERSON DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285405203",
            "telephone_number": "910-333-9712",
            "fax_number": "910-333-9715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOZIE",
        "first_name": "BENJAMIN",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-15",
        "last_updated": "2018-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2010-01876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

Verify at the official NPI Registry.