Individual provider Active NPI

Bryan S. Lantrip, M. D.

  • Diagnostic Radiology Physician
  • Jackson, MS
National Provider Identifier
1215942248
Registry record updated Jul 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
13254 Issued in MS
Practice address
969 Lakeland Dr
Jackson, MS 39216-4606
Phone
(877) 406-2916
Fax
(601) 682-7909
NPI assigned
Jul 29, 2006
Last updated
Jul 31, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 13254 MS Primary
Obesity Medicine (Internal Medicine) Physician 207RB0002X 13254 MS

Addresses

Primary practice location

969 Lakeland Dr
Jackson, MS 39216-4606

Mailing address

PO Box 55769
Jackson, MS 39296-5769
Phone (601) 200-6162

Other identifiers 3

IdentifierTypeStateIssuer
C00475OtherGROUP MEDICARE UPIN
00126008MedicaidMS
1861428351OtherGROUP NPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041008000111 MS Practitioner - Diagnostic Radiology 6103885744 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Mississippi School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeland Radiologists P aGroup PAC ID 4183683089, 29 clinicians

Practice addresses (Care Compare)

1001 Holland Ave
Philadelphia, MS 39350-2161
Phone (601) 781-2280

1026 N Flowood Dr
Flowood, MS 39232-9532
Phone (601) 933-6401

1030 River Oaks Dr
Flowood, MS 39232-9553
Phone (601) 936-2390

106 Highland Way
Madison, MS 39110-6929
Phone (601) 200-2000

1401 River Rd
Greenwood, MS 38930-4030
Phone (662) 459-7000

2100 Hwy 61 N
Vicksburg, MS 39183-8211
Phone (662) 883-5811

215 Marion Ave
McComb, MS 39648-2705
Phone (601) 249-1553

2510 Lakeland Dr
Flowood, MS 39232-9513
Phone (601) 355-1234

330 N Broad St
Forest, MS 39074-3508
Phone (601) 469-4151

409 Tyler Holmes Dr
Winona, MS 38967-1521
Phone (662) 283-4114

969 Lakeland Dr
Jackson, MS 39216-4606
Phone (601) 200-2000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
13254MSMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Radiologists P a Diagnostic Radiology CurrentSince Oct 1, 2001 Accepting new patients
St Dominic-Jackson Memorial Hospital Past Accepting new patients
Diagnostic X-Ray Physicians, PSC Diagnostic Radiology Past Accepting new patients

Locations

1401 River Rd
Greenwood, MS 38930
Phone (662) 459-2603

969 Lakeland Dr
Jackson, MS 39216
Phone (601) 200-4644

971 Lakeland Dr
Ste 950
Jackson, MS 39216
Phone (601) 362-6900

106 Highland Way
Ste 100
Madison, MS 39110
Phone (601) 200-8410

215 Marion Ave
McComb, MS 39648
Phone (601) 249-1180

2100 Highway 61 N
Vicksburg, MS 39183
Phone (601) 883-5001

409 Tyler Holmes Dr
Winona, MS 38967
Phone (662) 283-3060

Interoperability endpoints

  • Direct secure messaging: blantrip2548878@direct.casso.us.com

Organizations & group practices 3

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753920000000",
    "number": "1215942248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 55769",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392965769",
            "telephone_number": "601-200-6162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "969 LAKELAND DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164606",
            "telephone_number": "877-406-2916",
            "fax_number": "601-682-7909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANTRIP",
        "first_name": "BRYAN",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "M. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-29",
        "last_updated": "2025-07-31",
        "certification_date": "2025-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MS",
            "license": "13254",
            "primary": true
        },
        {
            "code": "207RB0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Obesity Medicine",
            "state": "MS",
            "license": "13254",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE UPIN",
            "identifier": "C00475",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00126008",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1861428351",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.