Jeffrey R. Moffett, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

R872112 Issued in MS

Practice address

3115 Audubon Dr
Laurel, MS 39440

Phone

(601) 531-2200

Fax

(601) 531-2220

NPI assigned

Sep 4, 2008

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 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Laurel Family Medicine LLCGroup PAC ID 0244584241, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Deaconess Homecare- Region I Home health agency, Laurel, MS, CCN 257085
• South Central Reg Med Ctr Hospital, Laurel, MS, CCN 250058

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/22845/brand/1/csg/1/fhir/r4
• Direct secure messaging: jeffrey.moffett.1@22845.direct.athenahealth.com

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.

• North Laurel Family Medicine, LLC

  • Nurse Practitioner
  • Laurel, MS
  • NPI 1265921985
  Medicare reassignment Care Compare group NPD

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

• South Central Regional Medical Center

  • General Acute Care Hospital
  • Laurel, MS
  • NPI 1619973542
  Care Compare affiliation
• South Mississippi Home Health, Inc. - Region I

  dba Deaconess HomeCare

  • Home Health Agency
  • Laurel, MS
  • NPI 1326039470
  Care Compare affiliation

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

{
    "created_epoch": "1220486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1710135629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3115 AUDUBON DR",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394401913",
            "telephone_number": "601-531-2200",
            "fax_number": "601-531-2220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3115 AUDUBON DR",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "39440",
            "telephone_number": "601-531-2200",
            "fax_number": "601-531-2220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOFFETT",
        "first_name": "JEFFREY",
        "middle_name": "R.",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-04",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "R872112",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00753295",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mindwell LLC
• Miracle Medical Supply, LLC
• Mississippi CVS Pharmacy, L.L.C. (CVS Pharmacy # 05777)
• Lydia S. Mitchell, COTA
• Gina H Mixon, RD
• Caliyah Z Moore, PCMHT
• Michael Moran, DMD
• Amy Sellers Morgan, D.M.D.
• Jacob Morgan, RN
• Mary Morgan

• Nurse Practitioner in Laurel, MS
• Providers in Laurel, MS by specialty
• Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2025; 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.