Thompson Mack Dietz IV, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

013772 Issued in LA

Practice address

1495 Gause Blvd
Slidell, LA 70458-2205

Phone

(985) 405-5200

Fax

(985) 405-5201

NPI assigned

Jun 15, 2005

Last updated

Feb 20, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Delta Diagnostics LLC

  • Diagnostic Radiology Physician
  • Slidell, LA
  • NPI 1942206487
  Authorized official Same address or phone
• Bayou Radiology, Inc

  • Diagnostic Radiology Physician
  • Cut Off, LA
  • NPI 1538127451
  NPD (past)
• Cardiothoracic Surgery, LLC

  • Surgery Physician
  • Metairie, LA
  • NPI 1689645392
  NPD (past)
• Delta Digital Diagnostics LLC

  dba MD Imaging

  • Diagnostic Radiology Physician
  • Slidell, LA
  • NPI 1487650933
  NPD (past)
• Delta Imaging LLC

  • Radiology Clinic/Center
  • Slidell, LA
  • NPI 1972509982
  NPD (past)
• Delta MRI LLC

  • Diagnostic Radiology Physician
  • New Orleans, LA
  • NPI 1134125693
  NPD (past)
• Diagnostic Imaging Services

  • Magnetic Resonance Imaging (MRI) Internal Medicine Physician
  • Metairie, LA
  • NPI 1699793166
  NPD (past)
• Hedge Diagnostics, Inc, Apmc

  • Diagnostic Radiology Physician
  • Lafayette, LA
  • NPI 1003803248
  NPD (past)
• Southwest Imaging Associates, Apmc

  • Diagnostic Radiology Physician
  • Lafayette, LA
  • NPI 1457348609
  NPD (past)

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

{
    "created_epoch": "1118793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203465600000",
    "number": "1083619241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8861",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700118861",
            "telephone_number": "985-405-5200",
            "fax_number": "985-405-5201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1495 GAUSE BLVD",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704582205",
            "telephone_number": "985-405-5200",
            "fax_number": "985-405-5201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETZ",
        "first_name": "THOMPSON",
        "middle_name": "MACK",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-15",
        "last_updated": "2008-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "LA",
            "license": "013772",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1323764",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diana L. Gillmore, M.D.,L.L.C.
• Bryan David Dibuono, M.D.
• Jennifer Brocato Diecidue, RN
• Ashley Perronne Dieck, RN
• Tami S Dietrich, PHARMD
• Diff3R3Nt Mentality, LLC
• Myles Christopher Digby, M.D.
• Steven Digiovanni
• Emily K Dileo
• Stacy Marie Diliberto, LCSW

• Diagnostic Radiology Physician in Slidell, LA
• Providers in Slidell, LA by specialty
• Diagnostic Radiology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2008; 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.