DESOTO DIAGNOSTIC IMAGING, LLC (NPI# 1083777882) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083777882 |
| Entity Type | Organization |
| Organization Name | DESOTO DIAGNOSTIC IMAGING, LLC |
| Other Organization Name | METHODIST DIAGNOSTIC CENTER, LLC |
| Practice Address |
9085 Sandidge Center Cove Suite 100 Olive Branch MS 38654-3575 |
| Practice Telephone | 6625361000 |
| Practice Fax Number | 6628938824 |
| Mailing Telephone | 6625361000 |
| Mailing Fax Number | 6628938824 |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2011-11-30 |
| Authorized Official Name | JOHN M GRAVES (PRESIDENT) |
| Authorized Official Telephone | 9015161410 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2471C3401X |
Radiologic Technologist Specialization: Computed Tomography |
Technologists, Technicians & Other Technical Service Providers | ||
| N | 2471C3402X |
Radiologic Technologist Specialization: Radiography |
Technologists, Technicians & Other Technical Service Providers | ||
| N | 2471M2300X |
Radiologic Technologist Specialization: Mammography |
Technologists, Technicians & Other Technical Service Providers | ||
| N | 2471N0900X |
Radiologic Technologist Specialization: Nuclear Medicine Technology |
Technologists, Technicians & Other Technical Service Providers | ||
| N | 2471S1302X |
Radiologic Technologist Specialization: Sonography |
Technologists, Technicians & Other Technical Service Providers | ||
| N | 2471V0105X |
Radiologic Technologist Specialization: Vascular Sonography |
Technologists, Technicians & Other Technical Service Providers | ||
| Y | 2471M1202X |
Radiologic Technologist Specialization: Magnetic Resonance Imaging |
Technologists, Technicians & Other Technical Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00973276 | 05 |
| Other Name | Type Code |
|---|---|
| Methodist Diagnostic Center, LLC | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881692325 | Desoto Diagnostic Imaging, LLC | Radiology | 201 N Beckley Ave, Flower Mound, TX 75115 | 2005-07-08 |
| Street Address |
9085 SANDIDGE CENTER COVE SUITE 100 |
| City | OLIVE BRANCH |
| State | MS |
| Zip Code | 38654-3575 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811931025 | Lynn T Carvel | Radiologic Technologist | 9085 Sandidge Center Cove, Olive Branch, MS 38654 | 2006-06-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093366213 | Latonya Shontae Binion | Home Health | 5915 Brice Cove North, Olive Branch, MS 38654 | 2019-09-28 |
| 1356828677 | Heath Bryan Coleman, Dds of Mississippi II, Pllc | Dentist | 688 Goodman Rd, Ste 123, Olive Branch, MS 38654 | 2018-07-20 |
| 1629565684 | Alexis Summerville Mcdavis | Pharmacist | 7950 Craft Goodman Frontage Rd, Olive Branch, MS 38654 | 2018-04-16 |
| 1194237206 | Exos Physical Therapy and Sports Medicine, LLC | Physical Therapist | 6542 Goodman Rd, Olive Branch, MS 38654 | 2017-10-30 |
| 1609386515 | Laken Hood Richardson | Physical Therapist | 9085 East Sandidge Cove, Suite 250, Olive Branch, MS 38654 | 2017-10-05 |
| 1275064255 | Heart of Hospice, LLC | Hospice Care, Community Based | 9849 Highway 178 Unit B, Olive Branch, MS 38654 | 2017-03-22 |
| 1023557865 | Michael Patrick Mccallum | Counselor | 9320 Railroad Ave., Olive Branch, MS 38654 | 2017-02-13 |
| 1891179768 | Desoto Children's Clinic - Olive Branch | Pediatrics | 7145 Goodman Road, Olive Branch, MS 38654 | 2015-07-10 |
| 1891185203 | Kristina Harper | Midwife | 9086 Pigeon Roost Rd Ste C, Olive Branch, MS 38654 | 2015-01-23 |
| 1275955098 | Global Medical | Durable Medical Equipment & Medical Supplies | 6229 Hwy 305 Ste L, Olivebranch, MS 38654 | 2014-01-14 |
| Find all providers in zip 38654 | ||||
| Taxonomy Code | 2471M1202X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Radiologic Technologist |
| Specialization | Magnetic Resonance Imaging |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760429682 | Regional Medical Support Center, Inc | Radiologic Technologist | 2115 13th St, Meridian, MS 39301-4045 | 2006-05-31 |
| 1750446753 | Preferred Billing Services | Radiologic Technologist | 575 Highway 6 E, Batesville, MS 38606-3003 | 2006-12-27 |
| 1184705725 | P and L Contracting, Inc. | Radiologic Technologist | 575 Highway 6 E, Batesville, MS 38606-3003 | 2006-10-18 |
| City | OLIVE BRANCH |
| Zip Code | 38654 |
Please comment or provide details below to improve the information on DESOTO DIAGNOSTIC IMAGING, LLC.
| 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.