PORTABLE MEDICAL DIAGNOSTICS LLC (NPI# 1730425547) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730425547 |
| Entity Type | Organization |
| Organization Name | PORTABLE MEDICAL DIAGNOSTICS LLC |
| Practice Address |
9047 Home Ave Irvington AL 36544-2855 |
| Mailing Address |
1855 Lakeland Dr Ste G10 Jackson MS 39216-4913 |
| Practice Telephone | 2512721080 |
| Practice Fax Number | 2512721080 |
| Mailing Telephone | 6019879729 |
| Mailing Fax Number | 6019870093 |
| Enumeration Date | 2012-12-26 |
| Last Update Date | 2014-07-21 |
| Authorized Official Name | DOUGLAS BROWN (MANAGING MEMBER) |
| Authorized Official Telephone | 6019879729 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 293D00000X | Physiological Laboratory | Laboratories |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | STATE BOARD OF HEALTH IPL LICENSE | 9074 | 01 |
| 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 |
| 1174804355 | Portable Medical Diagnostics LLC | Clinic/Center | 1855 Lakeland Dr, Ste G10, Jackson, MS 39216-4926 | 2011-09-01 |
| 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 |
9047 HOME AVE |
| City | IRVINGTON |
| State | AL |
| Zip Code | 36544-2855 |
| 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 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427671528 | Catherine Thompson | Social Worker | 12701 Padgett Switch Rd, Irvington, AL 36544 | 2020-05-22 |
| 1801937057 | Cheryl Berg Horn | Speech-Language Pathologist | 9780 Cornelius Rd., Irvington, AL 36544-0675 | 2007-02-09 |
| 1376894659 | South Mobile County Home Health Services Inc. | Case Management | 9161 Saint Elmo Cir S, Irvington, AL 36544-2921 | 2012-09-26 |
| 1740333236 | House of Philadelphia, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8571 Three Mile Rd, Irvington, AL 36544-3301 | 2007-01-19 |
| 1558683409 | South Alabama Leisure Rehabilitation Recreation Center Inc | Day Training, Developmentally Disabled Services | 8571 Three Mile Rd, Lot 4, Irvington, AL 36544-3301 | 2010-02-19 |
| 1902926884 | W.i.n.n.e.r.s., Inc | Substance Abuse Rehabilitation Facility | 8800 Three Mile Rd, Irvington, AL 36544-3334 | 2007-04-02 |
| 1952532566 | Wilsania L. Rodriguez Mendez | Internal Medicine | 12701 Padgett Switch Road, Medicine Dept., Irvington, AL 36544-4011 | 2009-07-30 |
| 1396794426 | Bayou La Batre Area Health Development Board, Inc. | Clinic/Center | 12701 Padgett Switch Rd, Irvington, AL 36544-4011 | 2006-05-08 |
| 1396360103 | Melissa Sprinkle | Nurse Practitioner | 12701 Padgett Switch Rd, Irvington, AL 36544-4011 | 2020-06-08 |
| 1275090300 | Michael A Pickert | Nurse Practitioner | 12701 Padgett Switch Rd, Irvington, AL 36544-4011 | 2019-02-25 |
| Find all providers in zip 36544 | ||||
| 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 |
|---|---|---|---|---|
| 1215101969 | Ronald P. Sinack | Physiological Laboratory | 701 Stuyvesant Ave, Irvington, NJ 07111-1823 | 2008-04-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922563147 | Alpha Vascular Screenings LLC | Physiological Laboratory | 190 Highland Blvd, Riverside, AL 35135-1050 | 2019-02-01 |
| 1679099253 | Vuepoint Diagnostics, LLC | Physiological Laboratory | 4268 Cahaba Heights Ct Ste 102, Vestavia, AL 35243-5711 | 2017-08-16 |
| 1588190441 | St Vincents Ambulatory Healthcare Network LLC | Physiological Laboratory | 7191 Cahaba Valley Rd Ste 104, Birmingham, AL 35242-6443 | 2017-05-11 |
| 1467623264 | Rural Imaging Southeast LLC | Physiological Laboratory | 781 4th Ave Ste A, York, AL 36925-2103 | 2008-03-19 |
| 1194934885 | Health Care Investment Group Inc | Physiological Laboratory | 218 W Alabama St, Florence, AL 35630-5516 | 2007-05-21 |
| 1316063100 | Breathtrac Inc | Physiological Laboratory | 131 Mccalla Rd, Bessemer, AL 35022-5329 | 2007-03-22 |
| 1295877215 | Premier Medical Development LLC | Physiological Laboratory | 405 E Barbour St Ste 4, Eufaula, AL 36027-1604 | 2007-02-13 |
| 1851476261 | Childersburg Diagnostic Imaging, LLC | Physiological Laboratory | 30411 Hwy 280, Childersburg, AL 35178 | 2006-10-25 |
| 1053414847 | Digital Diagnostic Imaging Inc | Physiological Laboratory | 416 W Dr Hicks Blvd, Florence, AL 35630-6101 | 2006-09-07 |
| 1922017516 | Instant Diagnostic Systems, Inc. | Physiological Laboratory | 1740 4th Ave Se, Suite A, Decatur, AL 35601-5900 | 2006-08-05 |
| Find all providers with the same taxonomy | ||||
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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.