Atlantic Diagnostic Services, LLC

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

Legal business name

ATLANTIC DIAGNOSTIC SERVICES, LLC

Practice address

165 W South Street
Suite 202
Hernando, MS 38632-2266

Phone

(855) 717-6838

Fax

(888) 371-4191

NPI assigned

Sep 13, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. John Pereira

Title

Managing Member

Phone

(662) 469-3000

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1379030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390867200000",
    "number": "1033544630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1785 NONCONNAH BOULEVARD",
            "address_2": "SUITE 107",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381322140",
            "telephone_number": "662-449-8200",
            "fax_number": "888-891-3929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 W SOUTH STREET",
            "address_2": "SUITE 202",
            "city": "HERNANDO",
            "state": "MS",
            "postal_code": "386322266",
            "telephone_number": "855-717-6838",
            "fax_number": "888-371-4191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIC DIAGNOSTIC SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-13",
        "last_updated": "2014-01-28",
        "status": "A",
        "authorized_official_last_name": "PEREIRA",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "662-469-3000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn Alred, FNP-C
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• All providers in Hernando, MS
• Physiological Laboratory in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.