Indianola Sleep Clinic, LLC

Primary specialty

Sleep Disorder Diagnostic Clinic/CenterTaxonomy code 261QS1200X

Legal business name

INDIANOLA SLEEP CLINIC, LLC

Doing business as

Rural Sleep Diagnostics

Practice address

103 W Jackson St
Belzoni, MS 39038-3500

Phone

(662) 887-3700

Fax

(888) 519-3773

NPI assigned

Jul 30, 2006

Last updated

Feb 15, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Brian K Herring

Title

Member

Phone

(662) 887-3700

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Rural Sleep Diagnostics Doing business as

Locations

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360886400000",
    "number": "1104831809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1151",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391301151",
            "telephone_number": "662-887-3700",
            "fax_number": "888-519-3773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 W JACKSON ST",
            "city": "BELZONI",
            "state": "MS",
            "postal_code": "390383500",
            "telephone_number": "662-887-3700",
            "fax_number": "888-519-3773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANOLA SLEEP CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2013-02-15",
        "status": "A",
        "authorized_official_last_name": "HERRING",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "662-887-3700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QS1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Sleep Disorder Diagnostic",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05073893",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE PROVIDER ID",
            "identifier": "20335479",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rural Sleep Diagnostics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Humphreys County Memorial Hospital
• Humphreys County Memorial Hospital
• Humphreys County Memorial Hospital
• Humphreys County Memorial Hospital
• Humphreys County Memorial Hospital (Church Street Clinic)
• Lee L James, P.T.
• Lori D Johnson, DDS
• Sanchasity Nicole Kimber
• Bryant W. Lary, R.P.T.
• Cherelle J Latiker

• Sleep Disorder Diagnostic Clinic/Center in Belzoni, MS
• Providers in Belzoni, MS by specialty
• Sleep Disorder Diagnostic Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2013; 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.