PORTABLE MEDICAL DIAGNOSTICS LLC (NPI# 1174804355) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1174804355 |
Entity Type | Organization |
Organization Name | PORTABLE MEDICAL DIAGNOSTICS LLC |
Practice Address |
1855 Lakeland Dr Ste G10 Jackson MS 39216-4926 |
Practice Telephone | 6019879729 |
Practice Fax Number | 6019870093 |
Mailing Telephone | 6019879729 |
Mailing Fax Number | 6019870093 |
Enumeration Date | 2011-09-01 |
Last Update Date | 2013-05-15 |
Authorized Official Name | DOUGLAS BROWN (MANAGING PARTNER) |
Authorized Official Telephone | 6012606008 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QR0208X |
Clinic/Center Specialization: Radiology, Mobile |
MS | Ambulatory Health Care Facilities |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1326384306 | Portable Medical Diagnostics LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 9047 Home Ave, Irvington, AL 36544-2855 | 2012-12-20 |
1730425547 | Portable Medical Diagnostics LLC | Physiological Laboratory | 9047 Home Ave, Irvington, AL 36544-2855 | 2012-12-26 |
1932489812 | Portable Medical Diagnostics LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 1855 Lakeland Dr, Ste G10, Jackson, MS 39216-4913 | 2011-08-23 |
Street Address |
1855 LAKELAND DR STE G10 |
City | JACKSON |
State | MS |
Zip Code | 39216-4926 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1508812694 | Mchanna & Associates, Inc. | Durable Medical Equipment & Medical Supplies | 1855 Lakeland Dr, Suite R204, Jackson, MS 39216-4913 | 2006-05-26 |
1104423268 | Emily Goeglein | Counselor | 1855 Lakeland Dr, Jackson, MS 39216-4913 | 2020-10-02 |
1972051522 | Daniel James Holloway | Nurse Practitioner | 1855 Lakeland Dr, Suite P-101, Jackson, MS 39216-4913 | 2016-09-13 |
1992161954 | Enhanced Wellness Living Pllc | Nurse Practitioner | 1855 Lakeland Dr, Ste M20, Jackson, MS 39216-4913 | 2016-01-06 |
1730552977 | Kaleigh Countiss | Counselor | 1855 Lakeland Dr, R305, Jackson, MS 39216-4913 | 2015-11-10 |
1104166891 | Lisa L Dalton | Nurse Practitioner | 1855 Lakeland Dr, Ste M20, Jackson, MS 39216-4913 | 2013-02-18 |
1932489812 | Portable Medical Diagnostics LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 1855 Lakeland Dr, Ste G10, Jackson, MS 39216-4913 | 2011-08-23 |
1003119041 | Denease Inez Bishop | Counselor | 1855 Lakeland Dr, Suite P101, Jackson, MS 39216-4913 | 2010-12-14 |
1790087393 | Jackson Psychiatry Group | Psychologist | 1855 Lakeland Dr, Suite P121, Jackson, MS 39216-4913 | 2010-12-02 |
1629378971 | Pmt Clinic | Psychologist | 1855 Lakeland Dr, Suite P101, Jackson, MS 39216-4913 | 2010-11-02 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1861011553 | Ashley Melancon Prewitt | Registered Nurse | St. Dominic's North Campus, Behavioral Health, Jackson, MS 39216 | 2020-04-13 |
1194353391 | Brianna Arrington | Student in an Organized Health Care Education/Training Program | Med/ Peds, 2500 N. State St., Jackson, MS 39216 | 2020-04-01 |
1720616485 | Roshina Khalid Khan | Student in an Organized Health Care Education/Training Program | Department of Anesthesiology, Ummc, 2500 N. State St., Jackson, MS 39216 | 2020-03-30 |
1275183550 | Amanda Lynn Morellato | Dentist | Ummc School of Dentistry, 2500 North State Street, Jackson, MS 39216 | 2019-09-18 |
1396305553 | Abhishek Chhabra | Student in an Organized Health Care Education/Training Program | Lakeland Family Medicine Clinic, 878 Lakeland Dr., Jackson, MS 39216 | 2019-06-19 |
1427615996 | Hometown Diagnostics | Clinical Medical Laboratory | Translational Research Center Tr311, 2500 North State Street, Jackson, MS 39216 | 2019-05-21 |
1346807773 | Shukundala C Smith | Behavior Technician | New Learning Resources 2510 Lakeland Terrace, Jackson, MS 39216 | 2019-05-21 |
1063901098 | G Eli Howell Md Pllc | Plastic Surgery | 971 Lakeland Dr Ste 225, Jackson, MS 39216 | 2018-05-04 |
1588168132 | Caleb Zumbro | Student in an Organized Health Care Education/Training Program | Ummc Med/peds, 2500 N. State St., Jackson, MS 39216 | 2018-03-20 |
1639677230 | Walgreen Co | Pharmacy | 971 Lakeland Dr Ste 101, Jackson, MS 39216 | 2018-01-29 |
Find all providers in zip 39216 |
Taxonomy Code | 261QR0208X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Radiology, Mobile |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1518284181 | Portable Medical Diagnostics Inc | Clinic/Center | 1855 Lakeland Dr, Suite G10, Jackson, MS 39216-4913 | 2010-04-22 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1760994396 | Have Scans Will Travel | Clinic/Center | 1138 Cloverdale Dr, Greenville, MS 38701-8301 | 2017-11-06 |
1356586762 | Pioneer Medical, LLC | Clinic/Center | 100 Clarendon Ave, Petal, MS 39465-2636 | 2008-12-14 |
1386185197 | Alliance Healthcare Services Inc | Clinic/Center | 1401 River Rd, Greenwood, MS 38930-4030 | 2017-03-13 |
1811138860 | Alliance Healthcare Services Inc | Clinic/Center | 581 Medical Dr, Clarksdale, MS 38614-6733 | 2009-03-19 |
1497820088 | Parker Imaging, LLC | Clinic/Center | 64 Main Street, Rienzi, MS 38865-9702 | 2006-11-21 |
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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.