MEDFUSION, LLC (NPI# 1407305030) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407305030 |
| Entity Type | Organization |
| Organization Name | MEDFUSION, LLC |
| Practice Address |
2 Old River Pl Suite C Jackson MS 39202-3435 |
| Mailing Address |
2 Old River Place Suite C Jackson MS 39202 |
| Practice Telephone | 6014795972 |
| Mailing Telephone | 6014795972 |
| Enumeration Date | 2016-09-23 |
| Last Update Date | 2016-09-23 |
| Authorized Official Name | MISTI MCNICHOLS (BUSINESS DEVELOPMENT CONSULTANT) |
| Authorized Official Telephone | 6014795972 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335V00000X | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | MS | Suppliers |
| Street Address |
2 OLD RIVER PL SUITE C |
| City | JACKSON |
| State | MS |
| Zip Code | 39202-3435 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427042134 | Buckner Prosthetic and Orthotic Laboratories Inc. | Prosthetist | 2 Old River Pl, Suite D, Jackson, MS 39202-3435 | 2005-09-08 |
| 1861830937 | Singleton and Myrick Incorporated | Prosthetic/Orthotic Supplier | 2 Old River Pl, Suite D, Jackson, MS 39202-3435 | 2013-06-11 |
| 1871887653 | Stephen James Singleton | Prosthetist | 2 Old River Pl, Suite D, Jackson, MS 39202-3435 | 2011-06-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982234183 | Eva Mackenzie Carmody | Physician Assistant | 1190 N State St Suite 502, Jackson, MS 39202 | 2020-01-16 |
| 1750868691 | Katherine Walters | Nurse Practitioner | 501 Marshall St., Suite 400, Jackson, MS 39202 | 2018-07-24 |
| 1932638749 | Tylan Lee | Social Worker | 860 East River Place Suite 100, Jackson, MS 39202 | 2017-06-06 |
| 1417314725 | Euna Jyles | Counselor | 860 E River Pl, Jackson, MS 39202 | 2016-01-19 |
| 1255712048 | Edward Jonathan Breight | Specialist/Technologist | 1325 East Fortication Street, Jackson, MS 39202 | 2015-06-17 |
| 1881037703 | Kara Spinks Logan | Surgery | 1190 N State St Ste 502, Jackson, MS 39202 | 2013-04-10 |
| 1477876530 | Mick Inc. | Technician | 334 Josanna Street, Suite #209, Jackson, MS 39202 | 2010-03-03 |
| 1073724910 | Paul Frederic Dare | Anesthesiology | 1151 North State St., Suite 311, Jackson Anesthesia Associates, Jackson, MS 39202 | 2007-05-24 |
| 1225247703 | Lynn Kincannon Holland | Counselor | 911 Manship Street, Unit A, Jackson, MS 39202 | 2007-05-22 |
| 1457568149 | Incare Inc | Pulmonary Function Technologist | 1151 North State St, Suite 406, Jackson, MS 39202 | 2007-05-16 |
| Find all providers in zip 39202 | ||||
| Taxonomy Code | 335V00000X |
| Grouping | Suppliers |
| Classification | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier |
| A supplier that provides one or more of the following portable services, including but not limited to, x-ray, electrocardiogram (EKG), long-term EKG (Holter Monitor), bone densitometry, sonography, and other imaging services in accordance with all state and federal requirements, under the general supervision of a qualified physician. All necessary resources are transported to the patient's location where the services are performed. |
| Notes: Source: National Uniform Claim Committee, 2015 [1/1/2016: title and definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992084172 | Accurate Medical Diagnostics, LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 660 Katherine Dr, Jackson, MS 39232-8847 | 2011-08-05 |
| 1487982922 | Bobchi Inverciones L.L.C. | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 3628 Shady Ridge Rd, Jackson, MI 49201-9352 | 2009-11-20 |
| 1851949291 | Dr Mobile Imaging, LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 18 Northland Dr, Jackson, TN 38301-3308 | 2019-08-29 |
| 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 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497117899 | Gamma Healthcare, Inc | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 3346 Goodman Rd E, Southaven, MS 38672-6433 | 2016-03-24 |
| 1093175838 | Precision Ultrasound Imaging Inc. | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 730 Ridgewood Rd Ste B, Ridgeland, MS 39157-4434 | 2016-03-04 |
| 1164496626 | Mississippi Mobile Diagnostics | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 730 Ridgewood Rd, Suite B, Ridgeland, MS 39157-4426 | 2006-02-13 |
| 1326040841 | Mobile Services, Inc | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 1807 24th Ave, Meridian, MS 39301-3116 | 2005-08-15 |
| 1114582848 | Total Imaging of Mississippi | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 1216 11th Ave, Meridian, MS 39301-4443 | 2019-05-08 |
| 1619204203 | Pioneer Medical Portable Xray,llc | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 100 Clarendon Ave, Petal, MS 39465-2636 | 2009-11-03 |
| 1912185927 | Jason H Clark & Sandra J Clark | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 139 County Road 379, Water Valley, MS 38965-3607 | 2008-02-01 |
| 1063625960 | Bladder Control Solutions, Inc | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 100 Maxwell Dr, Vicksburg, MS 39183 | 2007-05-07 |
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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.