SPECIALTY DIAGNOSTICS LLC (NPI# 1649764127) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649764127 |
| Entity Type | Organization |
| Organization Name | SPECIALTY DIAGNOSTICS LLC |
| Practice Address |
1149 Old Fannin Rd Ste 22 Brandon MS 39047 |
| Mailing Address |
1149 Old Fannin Rd Ste 22 Brandon MS 39047-9244 |
| Practice Telephone | 6015753392 |
| Mailing Telephone | 6015753392 |
| Enumeration Date | 2018-06-19 |
| Last Update Date | 2018-07-06 |
| Authorized Official Name | BARBARA BRADLEY (PARTNER) |
| Authorized Official Telephone | 6015753392 |
| Authorized Official Credential | CFNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 291U00000X | Clinical Medical Laboratory | Laboratories |
| Street Address |
1149 OLD FANNIN RD STE 22 |
| City | BRANDON |
| State | MS |
| Zip Code | 39047 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396368783 | Siyuan Chen Kennedy | Counselor | 108 Sandstone Drive, Brandon, MS 39047 | 2020-05-20 |
| 1568019784 | Juarez Brown Emerson | Registered Nurse | 426 Pinebrook Circle, Brandon, MS 39047 | 2019-08-22 |
| 1528423035 | Kathlene Strangeman | Social Worker | 111 Lakeshore Dr Apt G403, Brandon, MS 39047 | 2015-12-28 |
| 1174935076 | Anthony Davis | Counselor | 198 Bellegrove Cir, Brandon, MS 39047 | 2014-05-27 |
| 1144659178 | Medical Foundation of Central Ms, Inc | Family Medicine | 1887 Spillway Rd., Brandon, MS 39047 | 2013-11-12 |
| 1437429941 | Picton Timothy Evans | Pharmacist | 150 B Cumberland Ed, Brandon, MS 39047 | 2012-01-01 |
| 1275828030 | Kathryn Audell Piburn | Nurse Practitioner | 1887 Spillway Rd Ste 140, Brandon, MS 39047 | 2011-06-09 |
| 1801930532 | Susanne Reynolds Moore | Dentist | 1149 Old Fannin Rd, Suite 26, Brandon, MS 39047 | 2007-02-16 |
| 1194898429 | Brookshire Grocery Company | Durable Medical Equipment & Medical Supplies | 143 Plaza Drive Ext, Attention Pharmacy Dept, Brandon, MS 39047 | 2006-11-16 |
| 1972530632 | Claudia Weir Anthony | Nurse Practitioner | 1887 Spillway Rd, Brandon, MS 39047 | 2006-06-27 |
| Find all providers in zip 39047 | ||||
| Taxonomy Code | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588284087 | Brandon Hma LLC | Clinical Medical Laboratory | 350 Crossgates Blvd, Brandon, MS 39042-2601 | 2020-04-24 |
| 1871924977 | Sea Laboratories, LLC | Clinical Medical Laboratory | 519 E Bloomingdale Ave, Suite A, Brandon, FL 33511-8180 | 2013-11-29 |
| 1033251350 | Consultants Laboratory of Wi, LLC | Clinical Medical Laboratory | 601 E Clark St, Brandon, WI 53919-9549 | 2007-02-13 |
| 1164523478 | Hematopathology Associates LLC | Clinical Medical Laboratory | 653 W Lumsden Rd, Brandon, FL 33511-5911 | 2006-09-26 |
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| 1134699945 | Executive Diagnostics LLC | Clinical Medical Laboratory | 5455 Executive Pl Ste B, Jackson, MS 39206-4104 | 2018-12-05 |
| 1699287300 | Metric Lab Services LLC | Clinical Medical Laboratory | 116 Marketridge Dr, Ridgeland, MS 39157-6009 | 2017-11-03 |
| 1336660786 | Vitas Laboratory LLC | Clinical Medical Laboratory | 2048 Pineville Road, Suite B, Long Beach, MS 39560 | 2017-07-06 |
| 1275073405 | Marvel Laboratories, LLC | Clinical Medical Laboratory | 805 W Park Ave, Suite 5a, Greenwood, MS 38930-2832 | 2017-03-07 |
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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.