Jonathan W Shook, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

19308 Issued in MS

Practice address

101 Medical Park
Hattiesburg, MS 39401

Phone

(601) 579-3000

Fax

(601) 579-5240

NPI assigned

Aug 29, 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 1

Electronic endpoints 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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dshook2947@directpatientrecord.com

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.

• Forrest County General Hospital

  • Psychiatric Hospital Unit
  • Hattiesburg, MS
  • NPI 1295837631
  Medicare reassignment NPD
• Hattiesburg Clinic PA

  • Multi-Specialty Clinic/Center
  • Hattiesburg, MS
  • NPI 1740213446
  Medicare reassignment NPD
• Forrest County General Hospital

  • Rural Health Clinic/Center
  • Picayune, MS
  • NPI 1043820426
  NPD
• Hattiesburg Clinic, PA

  • Primary Care Clinic/Center
  • Flowood, MS
  • NPI 1912600354
  NPD
• Hattiesburg Clinic PA

  • Adolescent and Children Mental Health Clinic/Center
  • Hattiesburg, MS
  • NPI 1154410017
  NPD (past)
• Hattiesburg Clinic, PA

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Laurel, MS
  • NPI 1245263540
  NPD (past)
• State of Mississippi - University of Mississippi Medical Center

  • Critical Access Hospital
  • Lexington, MS
  • NPI 1386630705
  NPD (past)

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595376000000",
    "number": "1881703445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017246",
            "telephone_number": "601-268-3735",
            "fax_number": "601-579-5240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MEDICAL PARK",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "39401",
            "telephone_number": "601-579-3000",
            "fax_number": "601-579-5240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOOK",
        "first_name": "JONATHAN",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MS",
            "license": "19308",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04878346",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dshook2947@directpatientrecord.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "101 Medical Park",
            "city": "Hattiesburg",
            "state": "MS",
            "country_code": "US",
            "postal_code": "39401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Meghann C Sheppeard, MSN, FNP, B.C.
• Jennifer Baker Sheridan
• Richard Sheridan
• Randall L Sherman, MD
• Lauren Kelli Shoemake, MSW, LCSW
• Adrian Cromer Shuler
• Cory James Shumate, LPC
• Darvin L Sibley, CRNA
• David L Sicard, MD
• Ibrahima S Sidibe, MASSAGE THERAPIST

• Pediatrics Physician in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Pediatrics Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2020; 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.