Individual provider Active NPI

Shadell Cater, RDMS,RVT

  • Diagnostic Ultrasound Physician
  • Southaven, MS
National Provider Identifier
1063109767
Registry record updated Jul 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Ultrasound PhysicianTaxonomy code 2085U0001X
License
212797 Issued in CA
Practice address
7165 Swinnea Rd BLDG B2
Southaven, MS 38671-6361
Phone
(662) 612-4658
NPI assigned
Apr 21, 2023
Last updated
Jul 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Ultrasound Physician 2085U0001X 212797 CA Primary

Addresses

Primary practice location

7165 Swinnea Rd BLDG B2
Southaven, MS 38671-6361

Mailing address

7165 Swinnea Rd BLDG B2
Southaven, MS 38671-6361
Phone (662) 612-4658

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
212797CAMDDiagnostic Ultrasound Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cater Imaging Multi-Specialty Current Accepting new patients
Mommieandme3D4D Multi-Specialty CurrentSince May 14, 2023 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1682035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689638400000",
    "number": "1063109767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7165 SWINNEA RD BLDG B2",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386716361",
            "telephone_number": "662-612-4658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7165 SWINNEA RD BLDG B2",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386716361",
            "telephone_number": "662-612-4658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CATER",
        "first_name": "SHADELL",
        "credential": "RDMS,RVT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-21",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "CA",
            "license": "212797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southaven, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2023; 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.