Active NPI
Shadell Cater, RDMS,RVT
- Diagnostic Ultrasound Physician
- Southaven, MS
National Provider Identifier
1063109767
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Ultrasound Physician
- License
- 212797
- Practice address
- 7165 Swinnea Rd BLDG B2
Southaven, MS 38671-6361 - Phone
- (662) 612-4658
- NPI assigned
- Apr 21, 2023
- Last updated
- Jul 18, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 212797 | CA | MD | Diagnostic Ultrasound Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cater Imaging | Multi-Specialty | Current | Accepting new patients |
| Mommieandme3D4D | Multi-Specialty | Current | 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.