ATLANTIC DIAGNOSTIC SERVICES, LLC (NPI# 1033544630) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1033544630 |
Entity Type | Organization |
Organization Name | ATLANTIC DIAGNOSTIC SERVICES, LLC |
Practice Address |
165 W South Street Suite 202 Hernando MS 38632-2266 |
Mailing Address |
1785 Nonconnah Boulevard Suite 107 Memphis TN 38132-2140 |
Practice Telephone | 8557176838 |
Practice Fax Number | 8883714191 |
Mailing Telephone | 6624498200 |
Mailing Fax Number | 8888913929 |
Enumeration Date | 2013-09-13 |
Last Update Date | 2014-01-28 |
Authorized Official Name | MR. JOHN PEREIRA (MANAGING MEMBER) |
Authorized Official Telephone | 6624693000 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 293D00000X | Physiological Laboratory | Laboratories |
Street Address |
165 W SOUTH STREET SUITE 202 |
City | HERNANDO |
State | MS |
Zip Code | 38632-2266 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1275042335 | Dominic Lashay Freeman | Case Management | 2744 Hwy 51 South, Hernando, MS 38632 | 2017-09-21 |
1851814875 | Staci Lea Hudson | Nurse Practitioner | 2705 Hwy 51 South, Hernando, MS 38632 | 2017-07-21 |
1629425517 | Jamieka Harris | Counselor | 2705 Hwy 51 S, Hernando, MS 38632 | 2016-05-20 |
1215302476 | Elizabeth Claire Corban | Counselor | 2725 Highway 51 S., Hernando, MS 38632 | 2015-12-14 |
1669850004 | Jcc, LLC | Dentist | 1150 Monteith Avenue, Suite 102, Hernando, MS 38632 | 2015-05-18 |
1053701995 | Leigh Houston | Registered Nurse | 3104 Stonehenge Dr, Hernando, MS 38632 | 2015-01-30 |
1871831552 | Hernando Dental Group Incorporated | Dentist | 2264 Mcingvale Rd., Hernando, MS 38632 | 2013-01-30 |
1255677001 | Midsouth Medical Specialties, LLC | Pharmacy | 2260 Highway 515 South, Hernando, MS 38632 | 2012-12-26 |
1447506514 | Surgical First Assist, LLC | Specialist/Technologist, Other | 8921 Black Panther Cove, Herenando, MS 38632 | 2012-07-26 |
1629348396 | Stacy Riddle-mattox | Counselor | 2725 Highway 51 South, Hernando, MS 38632 | 2012-01-11 |
Find all providers in zip 38632 |
Taxonomy Code | 293D00000X |
Grouping | Laboratories |
Classification | Physiological Laboratory |
A laboratory that operates independently of a hospital and physician’s office to furnish physiological diagnostic services (e.g. EEG’s , EKG’s, scans, etc.). Facilities offering ONLY physiological services are not certified as independent laboratories. If an independent laboratory offers physiological services IN ADDITION to clinical laboratory services, they are surveyed only for compliance with the clinical laboratory regulations because there are no health and safety regulations for physiological services. |
Notes: Source: Paraphrased from the Medicare Carrier Manual, Section 2070.5. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1164807616 | Bd2 Preventative Services LLC | Physiological Laboratory | 201 Country Cove Cir, Clinton, MS 39056-9632 | 2015-07-27 |
1043305188 | Rest Well Sleep Diagnostics, LLC | Physiological Laboratory | 865 East Broad St., Monticello, MS 39654 | 2006-10-04 |
1295827004 | North Mississippi Spine Center, Inc | Physiological Laboratory | 109 Eureka Street, Suite B, Batesville, MS 38606 | 2006-09-29 |
1528096112 | South Central Regional Open Mri, LLC | Physiological Laboratory | 227 S 13th Ave, Laurel, MS 39440-4225 | 2006-06-30 |
1710935929 | Imaging Center of Meridian LLC | Physiological Laboratory | 2021 24th Ave, Suite B, Meridian, MS 39301-3121 | 2006-05-04 |
1205807237 | Open Mri. LLC | Physiological Laboratory | 14245 Dedeaux Rd, Gulfport, MS 39503-3369 | 2006-01-28 |
1083613699 | Imaging Center of Columbus, LLC | Physiological Laboratory | 2526 5th St N, Columbus, MS 39705-2019 | 2005-07-15 |
1497754030 | Open Air of Mslou LLC | Physiological Laboratory | 54 Seargent Prentiss Dr S, Suite 100, Natchez, MS 39120 | 2005-07-15 |
1144685561 | Sleepworks, Inc. | Physiological Laboratory | 1 Woodgreen Pl, Suite 211, Madison, MS 39110-8161 | 2015-12-30 |
1518330711 | Neuralogix Management, LLC | Physiological Laboratory | 232 Market St, Flowood, MS 39232-3339 | 2015-11-10 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.