Gulf Coast Imaging

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

GULF COAST IMAGING

Practice address

14245 Dedeaux Rd
Gulfport, MS 39503-3369

Phone

(228) 314-7226

Fax

(228) 314-7227

NPI assigned

Jul 27, 2006

Organization subpart

No

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

Authorized official

Name

William O Henry, MDNPI 1144363771

Title

President

Phone

(228) 314-7226

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• William O Henry, MD

  • Specialist
  • Gulfport, MS
  • NPI 1144363771
  NPD (past) Authorized official
• Rajesh Tuli, M.D.

  • Diagnostic Radiology Physician
  • Keesler Afb, MS
  • NPI 1982773412
  NPD (past)
• Shane Dennis Dieckman, D.O.

  • Diagnostic Radiology Physician
  • Offutt Afb, NE
  • NPI 1487647368
  NPD (past)
• Arne E Michalson, MD

  • Diagnostic Radiology Physician
  • Coeur D Alene, ID
  • NPI 1538161302
  NPD (past)

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358985600000",
    "number": "1205850773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2819",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395052819",
            "telephone_number": "228-314-7226",
            "fax_number": "228-314-7227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14245 DEDEAUX RD",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395033369",
            "telephone_number": "228-314-7226",
            "fax_number": "228-314-7227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULF COAST IMAGING",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-27",
        "last_updated": "2013-01-24",
        "status": "A",
        "authorized_official_last_name": "HENRY",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "228-314-7226",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10410",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03733573",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR DIANNA RAGULA",
            "identifier": "1154338879",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "16169",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gulf Coast Dental Center
• Gulf Coast Dermatology, PA
• Gulf Coast Ear Nose and Throat Associates, LLC
• Gulf Coast Endocrinology
• Gulf Coast Endodontic Associates, LLC
• Gulf Coast Interventional Pain Management Clinic, Inc
• Gulf Coast Interventional Pain Management Clinic, Inc.
• Gulf Coast Limb & Brace
• Gulf Coast Lung and Sleep Medicine Institute, LLC
• Gulf Coast Medical Transport LLC

• Specialist in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Specialist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 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.